The Italian Medicines Agency (AIFA), 181 via del Tritone, 00187, Rome, Italy.
The Italian Medicines Agency (AIFA), 181 via del Tritone, 00187, Rome, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 23, 25123, Brescia, Italy.
Health Policy. 2018 Jan;122(1):4-11. doi: 10.1016/j.healthpol.2017.09.006. Epub 2017 Sep 14.
Patients with multimorbidity have complex health needs but, due to the current traditional disease-oriented approach, they face a highly fragmented form of care that leads to inefficient, ineffective, and possibly harmful clinical interventions. There is limited evidence on available integrated and multidimensional care pathways for multimorbid patients. An expert consensus meeting was held to develop a framework for care of multimorbid patients that can be applied across Europe, within a project funded by the European Union; the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS). The experts included a diverse group representing care providers and patients, and included general practitioners, family medicine physicians, neurologists, geriatricians, internists, cardiologists, endocrinologists, diabetologists, epidemiologists, psychologists, and representatives from patient organizations. Sixteen components across five domains were identified (Delivery of Care; Decision Support; Self Management Support; Information Systems and Technology; and Social and Community Resources). The description and aim of each component are described in these guidelines, along with a summary of key characteristics and relevance to multimorbid patients. Due to the lack of evidence-based recommendations specific to multimorbid patients, this care model needs to be assessed and validated in different European settings to examine specifically how multimorbid patients will benefit from this care model, and whether certain components have more importance than others.
患有多种疾病的患者有复杂的健康需求,但由于目前传统的以疾病为导向的方法,他们面临着高度碎片化的护理形式,导致临床干预效率低下、无效,甚至可能有害。关于多病共存患者的现有综合和多维护理途径的证据有限。为了制定一个可以在整个欧洲应用的多病共存患者护理框架,一个由欧盟资助的项目——联合行动慢性病和促进全生命周期健康老龄化(JA-CHRODIS)组织了一次专家共识会议。这些专家代表了护理提供者和患者,包括全科医生、家庭医生、神经科医生、老年病学家、内科医生、心脏病专家、内分泌学家、糖尿病专家、流行病学家、心理学家以及患者组织的代表。在五个领域确定了 16 个组件(护理提供;决策支持;自我管理支持;信息系统和技术;以及社会和社区资源)。这些指南描述并说明了每个组件的目的,以及关键特征和与多病共存患者的相关性总结。由于缺乏针对多病共存患者的循证建议,因此需要在不同的欧洲环境中评估和验证这种护理模式,具体研究多病共存患者将如何从这种护理模式中受益,以及某些组件是否比其他组件更重要。