Harris Mark F, Dennis Sarah, Pillay Megan
MBBS, DRACOG, MD, Executive Director, Centre for Primary Health Care and Equity, University of New South Wales, New South Wales.
Aust Fam Physician. 2013 Dec;42(12):850-4.
Patients with multimorbidity are increasingly common in general practice. Multimorbidity is a challenge for both patients and practitioners because of the complexity of care and its impact on patients' lives. Single-disease-based guidelines are of limited use to providers managing patients with multimorbidity.
The article aims to discuss how multimorbidity can be best managed in general practice. It does this within the framework of a patient-centred approach that recognises the importance of finding common ground with patients in setting priorities and assessing the impact of care.
Providing effective care for multimorbidity requires shared decision-making about goals with patients and more effective communication and coordination between providers. For this group of patients, our current single-disease-based models of care need to be replaced with more integrated ones in which the impact of all the patient's conditions on their quality of life are considered.
患有多种疾病的患者在全科医疗中越来越常见。由于护理的复杂性及其对患者生活的影响，多种疾病对患者和从业者来说都是一项挑战。基于单一疾病的指南对管理患有多种疾病的患者的医疗服务提供者用处有限。
本文旨在讨论在全科医疗中如何最好地管理多种疾病。它是在以患者为中心的方法框架内进行讨论的，该方法认识到在确定优先事项和评估护理影响时与患者达成共识的重要性。
为患有多种疾病的患者提供有效护理需要与患者就目标进行共同决策，以及医疗服务提供者之间更有效的沟通与协调。对于这组患者，我们目前基于单一疾病的护理模式需要被更综合的模式所取代，在这种模式中要考虑患者所有病症对其生活质量的影响。
