Health behavior outcomes can help determine efficacy of interventions for multimorbidities

Intervention research focusing on patients with multiple, simultaneous chronic illnesses is a priority for health organizations such as the National Institutes of Health and Canadian Institutes of Health Research. This is important as physicians seek to better understand how one disease may influence the course of another coexisting one, and how to best care for patients who are battling multiple health issues. Researchers conducted a controlled trial in patients 18 to 80 years with three or more chronic conditions. They collected quantitative data and conducted in-depth interviews with patients, family members and health care providers, then measured the effectiveness of a four-month intervention based on changes in care delivery. For the study, health care professionals were trained to coach patients on adopting healthy lifestyle changes and managing their own health.

After four months, the intervention showed no effect on quantitative measures of self-management or self-efficacy. However, patients reported in qualitative interviews that the intervention improved their self-management and self-efficacy. The authors warn that complex interventions can be difficult to evaluate and important effects may be missed in evaluations that only include quantitative assessments.

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Scaling Up Patient-Centered Interdisciplinary Care for Multimorbidity: A Pragmatic Mixed-Methods Randomized Controlled Trial

Martin Fortin, MD, MSc, et al
Universite? de Sherbrooke, Sherbrooke, Québec, Canada


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