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Exploring patient priorities among long-term conditions in multimorbidity: a qualitative secondary analysis

Exploring patient priorities among long-term conditions in multimorbidity: a qualitative secondary analysis
Exploring patient priorities among long-term conditions in multimorbidity: a qualitative secondary analysis
Objective: A lack of agreement between health-care providers and patient priorities can impact the health-care provider–patient relationship, treatment concordance and potentially health outcomes. Evidence suggests that people living with multiple morbidities do prioritise among their long-term conditions. However, the evidence revealing the underlying reasons behind this prioritisation remains limited. Given the potential implications for day-to-day self-management activity and ultimately patient outcomes, this study aims to explore how and why people with multimorbidity prioritise some long-term conditions over others and what the potential implications may be for self-management activity, and in turn, suggest how such information may help clinicians negotiate the management of multimorbidity patients.

Methods: A secondary analysis of qualitative data was conducted utilising four existing data sets collated from the three research centres involved. Purposive sampling provided a sample of 41 participants who had multimorbidity. The research team collectively coded and analysed the data thematically.

Results: All participants, except two, identified one ‘main’ priority long-term condition. Current priorities were arrived at by participants making comparisons between their long-term conditions, specifically by trading off the various attributes, impacts and perceived consequences of their individual long-term conditions. Two main themes emerged as to why participants identified a particular main long-term condition: (a) proximate issues surrounding barriers to functional health and (b) prioritisation of long-term conditions perceived to have a particular future risk.

Conclusions: The recent focus on multimorbidity within the medical literature reflects its prevalence. It is therefore important to understand the complexities of the multimorbidity illness experience. We have added to the limited literature on condition prioritisation by revealing some novel understandings of the process of condition prioritisation which can feed into patient–provider consultations in order to allow better communication and treatment planning as well as, ultimately, optimise patient outcomes.
multimorbidity, primary care, priorities, self-management, risk
1-9
Cheraghi-Sohi, S.
6357aeb4-ee87-4c15-aee2-594d243a4059
Morden, A.
9a4bd962-7ac5-4f73-b786-a30d67b8373b
Bower, P.
a1242859-1e67-4fb3-85a7-35ebffc4ada7
Kennedy, Anne
e059c1c7-d6d0-41c8-95e1-95e5273b07f8
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Richardson, J.
e25f154e-4705-443e-a996-58e774c54b70
Sanders, T.
21c62939-f6fd-49c7-8527-53e9737e1599
Stevenson, Fiona
881eb2a9-d7a8-449d-be50-ead6fda5cd3e
Ong, Bie N.
a7d013b7-f88d-49ba-8650-2cc1511f59fb
Cheraghi-Sohi, S.
6357aeb4-ee87-4c15-aee2-594d243a4059
Morden, A.
9a4bd962-7ac5-4f73-b786-a30d67b8373b
Bower, P.
a1242859-1e67-4fb3-85a7-35ebffc4ada7
Kennedy, Anne
e059c1c7-d6d0-41c8-95e1-95e5273b07f8
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Richardson, J.
e25f154e-4705-443e-a996-58e774c54b70
Sanders, T.
21c62939-f6fd-49c7-8527-53e9737e1599
Stevenson, Fiona
881eb2a9-d7a8-449d-be50-ead6fda5cd3e
Ong, Bie N.
a7d013b7-f88d-49ba-8650-2cc1511f59fb

Cheraghi-Sohi, S., Morden, A., Bower, P., Kennedy, Anne, Rogers, Anne, Richardson, J., Sanders, T., Stevenson, Fiona and Ong, Bie N. (2013) Exploring patient priorities among long-term conditions in multimorbidity: a qualitative secondary analysis. Sage Open Medicine, 1, 1-9. (doi:10.1177/2050312113503955).

Record type: Article

Abstract

Objective: A lack of agreement between health-care providers and patient priorities can impact the health-care provider–patient relationship, treatment concordance and potentially health outcomes. Evidence suggests that people living with multiple morbidities do prioritise among their long-term conditions. However, the evidence revealing the underlying reasons behind this prioritisation remains limited. Given the potential implications for day-to-day self-management activity and ultimately patient outcomes, this study aims to explore how and why people with multimorbidity prioritise some long-term conditions over others and what the potential implications may be for self-management activity, and in turn, suggest how such information may help clinicians negotiate the management of multimorbidity patients.

Methods: A secondary analysis of qualitative data was conducted utilising four existing data sets collated from the three research centres involved. Purposive sampling provided a sample of 41 participants who had multimorbidity. The research team collectively coded and analysed the data thematically.

Results: All participants, except two, identified one ‘main’ priority long-term condition. Current priorities were arrived at by participants making comparisons between their long-term conditions, specifically by trading off the various attributes, impacts and perceived consequences of their individual long-term conditions. Two main themes emerged as to why participants identified a particular main long-term condition: (a) proximate issues surrounding barriers to functional health and (b) prioritisation of long-term conditions perceived to have a particular future risk.

Conclusions: The recent focus on multimorbidity within the medical literature reflects its prevalence. It is therefore important to understand the complexities of the multimorbidity illness experience. We have added to the limited literature on condition prioritisation by revealing some novel understandings of the process of condition prioritisation which can feed into patient–provider consultations in order to allow better communication and treatment planning as well as, ultimately, optimise patient outcomes.

Full text not available from this repository.

More information

Published date: December 2013
Keywords: multimorbidity, primary care, priorities, self-management, risk
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 366100
URI: https://eprints.soton.ac.uk/id/eprint/366100
PURE UUID: acad8ec2-875a-417d-a9cf-9f1643db5152
ORCID for Anne Kennedy: ORCID iD orcid.org/0000-0003-4570-9104

Catalogue record

Date deposited: 24 Jun 2014 12:10
Last modified: 06 Jun 2018 12:28

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