Redesigning primary care for the people who use it

Unveiling the results of the 3D trial for patients with multimorbidity in general practice

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by Chris Salibsury, Peter Bower, Stewart Mercer and Bruce Guthrie

There is good agreement about the sort of care that people with multimorbidity need. But can it be delivered in the busy setting of general practice, and does it improve outcomes? In this blog we discuss the results of the 3D trial, the largest study of an intervention for multimorbidity published to date.

Managing multimorbidity is a litmus test for modern health care systems. Patients with many long-term conditions face major challenges in managing their conditions and need significant support, which means that these patients are often associated with high costs.

Despite the complexity of caring for these patients, there is also significant agreement about what sort of care they need. Many authors have highlighted that patient-centred care is crucial, … Read more

Multimorbidity Treatment Burden Questionnaire (MTBQ) – a new measure of treatment burden

 

 

 

 

By Dr Polly Duncan and Professor Chris Salisbury
Centre for Academic Primary Care

We have developed a new, simply-worded, concise questionnaire – the Multimorbidity Treatment Burden Questionnaire (MTBQ) – to measure treatment burden in patients with multimorbidity (multiple long-term conditions).

Treatment burden is the perceived effort of looking after one’s health and the impact this has on day-to-day life. It includes everything that the patient has to do to look after their health including: ordering, collecting and taking medicines; coordinating and arranging transport for, and attending, health appointments with multiple health professionals; monitoring blood sugar or blood pressure levels; learning about own health conditions; and taking on lifestyle advice.

To understand how new health care interventions impact on treatment burden, we need to be able to measure it. A recent study published in the Annals of Family Medicine highlighted treatment burden as one of the core … Read more

Collaborative action planning is key to person-centred healthcare but how can we make it happen?

 

by Cindy Mann
Senior Research Associate
Centre for Academic Primary Care
@Jcindymann


Person-centred healthcare
is accepted as desirable on moral grounds and because it potentially leads to better health outcomes, greater efficiency and less waste. It means both involvement of individuals in their healthcare and individualisation of care.

The NHS has been chasing the goal of person-centred care planning for several years and there are many good examples of innovation. The ‘House of Care’ describes what it might mean in practice for people with long-term conditions. At its heart is personalised care planning, taking account of patients’ expressed needs and priorities. The national new models of care programme, involving 50 vanguard sites, is also pursuing this goal and recently reported on lessons learnt. Many of the vanguards have invested in health coaching and communication skills training for clinicians.

I recently worked on a large research project, … Read more