Current approaches to medical care optimization for patients with multimorbidity

Scientific interest to the problem of multimorbidity is increasing due to the increase of the number of such patients. The aim of this work  was to analyze and summarize current approaches to optimizing care for patients with multimorbidity and the results of their implementation in clinical practic...

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Main Authors: D.D. Diachuk, I.M. Hidzynska, G.Z. Moroz, I.M. Tkachuk
Format: Article
Language:English
Published: Dnipro State Medical University 2020-12-01
Series:Medičnì Perspektivi
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Online Access:http://journals.uran.ua/index.php/2307-0404/article/view/221220
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author D.D. Diachuk
I.M. Hidzynska
G.Z. Moroz
I.M. Tkachuk
author_facet D.D. Diachuk
I.M. Hidzynska
G.Z. Moroz
I.M. Tkachuk
author_sort D.D. Diachuk
collection DOAJ
description Scientific interest to the problem of multimorbidity is increasing due to the increase of the number of such patients. The aim of this work  was to analyze and summarize current approaches to optimizing care for patients with multimorbidity and the results of their implementation in clinical practice. Since the beginning of this century, a number of documents have been created by WHO, government agencies and professional medical societies to improve medical care to patients with multimorbidity. The evidential basis of the effectiveness of the majority of the proposed measures based primarily on expert consensus. In 2016 NICE has published a clinical guideline NG56 «Multimorbidity: clinical assessment and management», WHO – a monograph  «Multimorbidity: Technical Series on Safer Primary Care». In 2017 NICE has published a quality standard – Quality Standard №153 «Multimorbidity». The strategy of improvement of medical care for patients with multimorbidity is directly related to the patient-centered approach formation, which includes comprehensive assessment of the patient's condition. The main component of medical care is the definition of a realistic goal of medical intervention according to patient`s preferences, and making the choice of the optimal amount of diagnostic, treatment, and preventive measures, which can lead to the desired goal. A number of studies (the 3D randomized controlled trial, the MultiCare AGENDA, the SPPiRE study, the WestGem study etc.) have being conducted to evaluate the effectiveness of implementing proposed approaches in clinical practice. The results of the studies and meta-analysis do not provide conclusive evidence of the medical and economic effectiveness of their implementation at the presentstage. Improving the outcomes of medical care to patients with multimorbidity involves conducting further clinical trials that can provide evidence to determine the list of most effective interventions for clinical practice.
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spelling doaj-art-fd785b8f4a734047b3b11d3ee365cab92025-01-02T06:58:49ZengDnipro State Medical UniversityMedičnì Perspektivi2307-04042020-12-0125441110.26641/2307-0404.2020.4.221220221220Current approaches to medical care optimization for patients with multimorbidityD.D. Diachuk0I.M. Hidzynska1G.Z. Moroz2I.M. Tkachuk3State Institution of Sciences “Research and Practical Center of Preventive and Clinical Medicine”, State Administrative Department, Verchnia str., 5, Kyiv, 01014State Institution of Sciences “Research and Practical Center of Preventive and Clinical Medicine” , State Administrative Department, Verchnia str., 5, Kyiv, 01014State Institution of Sciences “Research and Practical Center of Preventive and Clinical Medicine”, State Administrative Department, Verchnia str., 5, Kyiv, 01014; Ukrainian Military Medical Academy, Moskovska str., 45/1, Kyiv, 01015Ukrainian Military Medical Academy, Moskovska str., 45/1, Kyiv, 01015Scientific interest to the problem of multimorbidity is increasing due to the increase of the number of such patients. The aim of this work  was to analyze and summarize current approaches to optimizing care for patients with multimorbidity and the results of their implementation in clinical practice. Since the beginning of this century, a number of documents have been created by WHO, government agencies and professional medical societies to improve medical care to patients with multimorbidity. The evidential basis of the effectiveness of the majority of the proposed measures based primarily on expert consensus. In 2016 NICE has published a clinical guideline NG56 «Multimorbidity: clinical assessment and management», WHO – a monograph  «Multimorbidity: Technical Series on Safer Primary Care». In 2017 NICE has published a quality standard – Quality Standard №153 «Multimorbidity». The strategy of improvement of medical care for patients with multimorbidity is directly related to the patient-centered approach formation, which includes comprehensive assessment of the patient's condition. The main component of medical care is the definition of a realistic goal of medical intervention according to patient`s preferences, and making the choice of the optimal amount of diagnostic, treatment, and preventive measures, which can lead to the desired goal. A number of studies (the 3D randomized controlled trial, the MultiCare AGENDA, the SPPiRE study, the WestGem study etc.) have being conducted to evaluate the effectiveness of implementing proposed approaches in clinical practice. The results of the studies and meta-analysis do not provide conclusive evidence of the medical and economic effectiveness of their implementation at the presentstage. Improving the outcomes of medical care to patients with multimorbidity involves conducting further clinical trials that can provide evidence to determine the list of most effective interventions for clinical practice.http://journals.uran.ua/index.php/2307-0404/article/view/221220multimorbidity, patient-centered care, guidelines
spellingShingle D.D. Diachuk
I.M. Hidzynska
G.Z. Moroz
I.M. Tkachuk
Current approaches to medical care optimization for patients with multimorbidity
Medičnì Perspektivi
multimorbidity, patient-centered care, guidelines
title Current approaches to medical care optimization for patients with multimorbidity
title_full Current approaches to medical care optimization for patients with multimorbidity
title_fullStr Current approaches to medical care optimization for patients with multimorbidity
title_full_unstemmed Current approaches to medical care optimization for patients with multimorbidity
title_short Current approaches to medical care optimization for patients with multimorbidity
title_sort current approaches to medical care optimization for patients with multimorbidity
topic multimorbidity, patient-centered care, guidelines
url http://journals.uran.ua/index.php/2307-0404/article/view/221220
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AT imtkachuk currentapproachestomedicalcareoptimizationforpatientswithmultimorbidity