Hello! I’m Katherine, a 4th-year medical student, who - over the last 5 weeks - has been updating the multimorbidity literature database for the period 1st July-31st December 2024. While completing this I identified a topic within the recent multimorbidity publications that interested me, from which I then wrote a report as part of my Student Selected Component on Academic Research in General Practice.

The categories chosen for the database were as follows:

  1. Epidemiology of multimorbidity: Predictors and Patterns
  2. Epidemiology of multimorbidity: Outcomes
  3. Polypharmacy
  4. Management of multimorbidity
  5. Qualitative work – experience and perspectives
  6. Multimorbidity policy and editorials

The initial search included 1466 articles, after exclusions were applied, 295 publications specifically focused on multimorbidity within one of the domains above.

The topic I chose to focus on was the use of person-centred care (PCC) in managing multimorbid patients from areas of higher socioeconomic deprivation. Three publications from the search covered this theme. The publications' discussions of how socioeconomic status influenced engagement in healthcare and how multimorbidity management could be improved by tailoring interventions to fit this population drew my interest.

Person-centred care (PCC) is known to improve outcomes in those with multiple long-term conditions. However, guidance for providing PCC has not been influenced by the needs of those from areas of socioeconomic deprivation despite being a group with a higher prevalence of multimorbidity. The three publications I focused on highlighted the principles that patients from areas of higher socioeconomic deprivation valued most in the delivery of their healthcare while also discussing potential barriers.

There were many shared points made between the publications. Notably, McCallum et al. and van Bommel et al. described how patients valued being seen as a person with their individual needs (a key principle of PCC) and not defined by their conditions or their health issues and that this drove engagement in healthcare.1,2 A barrier to the delivery of PCC discussed by both McCallum et al. and Zezai et al. was the stigmatisation and discrimination of communities.1,3 Many individuals felt a sense of “belonging” within their communities, however, healthcare was seen as “outside” this collectiveness.1,3 Patients felt they would experience stigma and discrimination on attempting to use services, and unfortunately, these beliefs were often validated by experience.1,3 The articles evidence the importance of PCC in multimorbidity, particularly in areas of higher socioeconomic deprivation, and the value these patients place on healthcare providers who empathetically and collaboratively involve them in their care.

References

  1. McCallum M, Macdonald S, Mair FS. Multimorbidity and person-centred care in a socioeconomically deprived community: a qualitative study. British Journal of General Practice. 2024.
  2. van Bommel H, Raaijmakers LHA, van den Muijsenbergh M, Schermer T, Burgers JS, van Loenen T, et al. Patient experiences with person-centred and integrated chronic care, focussing on patients with low socioeconomic status: a qualitative study. British Journal of General Practice. 2024.
  3. Zezai D, van Rensburg AJ, Babatunde GB, Kathree T, Cornick R, Levitt N, et al. Barriers and facilitators for strengthening primary health systems for person-centred multimorbid care in low-income and middle-income countries: a scoping review. BMJ Open. 2024.

 

 

First published: 12 February 2025

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