Multimorbidity Management: Challenges, Interventions, and Patient-Centered Care in Primary Healthcare for Chronic Conditions

Mohammed Taresh Alshammari; Bunaydir Aali almotairi; Reem Sultan Alshaibani; Bashair Maqbool Alharbi; Munirah Nassar Arabi; Maryam Helal Alanazi; ‏Layla Aqeel Alanizi; ‏Aljazi Awadh AlAni; Afnan Mohammed Al Dosari; Eman Ibrahim Alshaikh Ali; Khwlah Abdulaziz Alswaied; Mohammed Naif Al Mutairi; Abdulkarim Shunayn Safi Alanazi; Fahad Husayyan Al Enazi; Bander Nasser Alharbi

doi:10.25163/angiotherapy.72110112

Integrative Biomedical Research

Integrative Biomedical Research (Journal of Angiotherapy) | Online ISSN 3068-6326

463

Citations

1.8m

Views

757

Articles

Submit

Volume 7 Number 2 2023

Figures and Tables

REVIEWS (Open Access)

Previous Next Contents Vol 7 (2)

Multimorbidity Management: Challenges, Interventions, and Patient-Centered Care in Primary Healthcare for Chronic Conditions

Mohammed Taresh Alshammari ¹*, Bunaydir Aali almotairi ¹, Reem Sultan Alshaibani ¹, Bashair Maqbool Alharbi ¹, Munirah Nassar Arabi ¹, Maryam Helal Alanazi ¹, ‏Layla Aqeel Alanizi ¹, ‏Aljazi Awadh AlAni ¹, Afnan Mohammed Al Dosari ¹, Eman Ibrahim Alshaikh Ali ¹, Khwlah Abdulaziz Alswaied ¹, Mohammed Naif Al Mutairi ¹, Abdulkarim Shunayn Safi Alanazi ¹, Fahad Husayyan Al Enazi ¹, Bander Nasser Alharbi ¹

+ Author Affiliations

Journal of Angiotherapy 7 (2) 1-6 https://doi.org/10.25163/angiotherapy.72110112

Submitted: 21 October 2023 Revised: 29 December 2023 Published: 30 December 2023

Abstract

Background: Multimorbidity, the coexistence of multiple chronic conditions, presents significant challenges to health systems worldwide. The increasing prevalence of multimorbidity among aging populations necessitates innovative strategies to optimize healthcare delivery, enhance medication adherence, and improve patient-centered outcomes. Despite advancements in technology and interventions, gaps remain in understanding how best to address multimorbidity’s complexities, particularly in socioeconomically deprived regions and specialized fields like precision personalized medicine. Methods: A systematic review of recent studies and meta-analyses was conducted, focusing on interventions to improve outcomes in multimorbid patients. Data sources included randomized controlled trials, observational studies, and systematic reviews from 2000 to 2023. Interventions were categorized into behavior change techniques, mobile health (mHealth) solutions, and patient-centered care models. Case studies from projects in livestock farming and precision medicine were incorporated to explore multidisciplinary applications, including nanotechnology and the development of antibiotic-free solutions. Results: The review highlighted that patient-centered care models, such as the 3D approach, significantly improved the quality of life and reduced unplanned hospital admissions among patients with multimorbidity. mHealth interventions, including SMS reminders and mobile apps, enhanced medication adherence by up to 20%, with interactive voice response systems showing similar benefits. Integrated care models leveraging information and communication technology demonstrated promise in managing multimorbidity among older adults. Additionally, the application of nanotechnology in precision medicine and agriculture, particularly in antibiotic-free broiler production, provided novel insights into addressing health and environmental challenges simultaneously. Conclusion: Addressing multimorbidity requires an interdisciplinary approach that integrates patient-centered care, technological innovation, and evidence-based interventions. While mHealth solutions and behavior change techniques hold substantial potential, their success depends on tailoring interventions to individual patient needs and socioeconomic contexts. Future research should emphasize scalability and the integration of cutting-edge technologies, such as nanotechnology, to improve health outcomes across diverse populations. Collaborative efforts between healthcare providers, researchers, and policymakers are essential to ensure sustainable and equitable advancements in multimorbidity management.

Keywords: multimorbidity, primary care, chronic conditions, patient-centered care, healthcare interventions

References

Abraham, C., & Michie, S. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology, 27(3), 379-387. https://doi.org/10.1037/0278-6133.27.3.379

Almirall, J., & Fortin, M. (2013). The coexistence of terms to describe the presence of multiple concurrent diseases. Journal of Comorbidity, 3, 4-9. https://doi.org/10.15256/joc.2013.3.22

Barnett, K., Mercer, S., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for healthcare, research, and medical education: A cross-sectional study. The Lancet, 380, 37-43. https://doi.org/10.1016/S0140-6736(12)60240-2

Bayliss, E., Bayliss, M., Ware, J., & Steiner, J. (2004). Predicting declines in physical function in persons with multiple chronic medical conditions: What we can learn from the medical problem list. Health and Quality of Life Outcomes, 2(1), 47. https://doi.org/10.1186/1477-7525-2-47

Bosma, R., Bisson, E. J., Cooper, L. K., Salomons, T. V., Galica, J., & Wilson, R. (2023). Experience-based design: Empowering individuals while they wait for interprofessional chronic pain care. Patient Education and Counseling, 109, 107623. https://doi.org/10.1016/j.pec.2023.107623

Boyd, C. M., & Fortin, M. (2010). Future of multimorbidity research: How should understanding multimorbidity inform health system design? Future Multimorbidity Research: How Should Understanding Multimorbidity Inform Health System Design, 32, 451-474. https://doi.org/10.1007/BF03391611

Dekoekkoek, T., Given, B., Given, C. W., Ridenour, K., Schueller, M., & Spoelstra, S. L. (2015). mHealth SMS text messaging interventions and promoting medication adherence: An integrative review. Journal of Clinical Nursing, 24(19-20), 2722-2735. https://doi.org/10.1111/jocn.12918

Duerden, M., Avery, T., & Payne, R. (2015). Polypharmacy and medicines optimization.

Fisher, K., Markle-Reid, M., Ploeg, J., et al. (2020). Self-management program versus usual care for community-dwelling older adults with multimorbidity: A pragmatic randomized controlled trial in Ontario, Canada. Journal of Comorbidity, 10, 2235042X20963390. https://doi.org/10.1177/2235042X20963390

Fortin, M., Bravo, G., Hudon, C., Lapointe, L., Dubois, M. F., & Almirall, J. (2006). Psychological distress and multimorbidity in primary care. Annals of Family Medicine, 4(5), 417-422. https://doi.org/10.1370/afm.528

Fortin, M., Dionne, J., Pinho, G., Gignac, J., Almirall, J., & Lapointe, L. (2006). Randomized clinical trials: Do they have external validity for patients with multiple comorbidities? Annals of Family Medicine, 4(2), 104-108. https://doi.org/10.1370/afm.516

Fortin, M., Soubhi, H., Hudon, C., Bayliss, E., & van den Akker, M. (2007). Multimorbidity's many challenges. BMJ, 334(7602), 1016-1017. https://doi.org/10.1136/bmj.39201.463819.2C

Gunn, J. M., Ayton, D. R., Densley, K., Pallant, J. F., Chondros, P., & Herrman, H. E. (2012). The association between chronic illness, multimorbidity, and depressive symptoms in an Australian primary care cohort. Social Psychiatry and Psychiatric Epidemiology, 47(2), 175-184. https://doi.org/10.1007/s00127-010-0330-z

Higgins, J., Thomas, J., Chandler, J., et al. (2020). Cochrane handbook for systematic reviews of interventions version 6.1. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/9781119536604

May, C. R., Eton, D. T., Boehmer, K., et al. (2014). Rethinking the patient: Using Burden of Treatment Theory to understand the changing dynamics of illness. BMC Health Services Research, 14(1), 281. https://doi.org/10.1186/1472-6963-14-281

Muth, C., Blom, J. W., et al. (2018). Evidence supporting the best clinical management of patients with multimorbidity and polypharmacy: A systematic guideline review and expert consensus. Journal of Internal Medicine.

Noël, P. H., Parchman, M. L., Williams, J. W. Jr., Cornell, J. E., Shuko, L., Zeber, J. E., Kazis, L. E., Lee, A. F., & Pugh, J. A. (2007). The challenges of multimorbidity from the patient perspective. Journal of General Internal Medicine, 22(Suppl 3), 419-424. https://doi.org/10.1007/s11606-007-0308-z

Nieuwlaat, R., Wilczynski, N., Navarro, T., Hobson, N., Jeffery, R., Keepanasseril, A., Agoritsas, T., Mistry, N., Iorio, A., Jack, S., Sivaramalingam, B., Iserman, E., Mustafa, R. A., Jedraszewski, D., Cotoi, C., & Haynes, R. B. (2014). Interventions for enhancing medication adherence. Cochrane Database of Systematic Reviews, 2014(11), CD000011. https://doi.org/10.1002/14651858.CD000011.pub4

Prados-Torres, A., Cura-González, I. D., Prados-Torres, J. D., et al. (2020). MULTIPAP study: Improving healthcare for patients with multimorbidity. British Journal of General Practice, 70(Suppl 1). https://doi.org/10.3399/bjgp20X711257

Ryan, A., Wallace, E., O'Hara, P., & Smith, S. M. (2015). Multimorbidity and functional decline in community-dwelling adults: A systematic review. Health and Quality of Life Outcomes, 13(168). https://doi.org/10.1186/s12955-015-0355-9

Article metrics

View details

Downloads

Citations

2708

Views

📥 PDF ▾

📖 Cite article

View Dimensions

View Plumx

View Altmetric

1
Save

0
Citation

2708
View

2
Share

Integrative Biomedical Research

Article Contents

Multimorbidity Management: Challenges, Interventions, and Patient-Centered Care in Primary Healthcare for Chronic Conditions

Abstract

References

Stay connected