Institute for Health and Society, Newcastle University, UK.
Newcastle University Institute for Ageing, Newcastle University, UK.
Age Ageing. 2019 May 1;48(3):401-406. doi: 10.1093/ageing/afz014.
multiple conditions in later life (multi-morbidity) is a major challenge for health and care systems worldwide, is of particular relevance for older people, but has not (until recently) received high priority as a topic for research. We have identified the top 10 research priorities from the perspective of older people, their carers, and health and social care professionals using the methods of a James Lind Alliance Priority Setting Partnership.
in total, 354 participants (162 older people and carers, 192 health professionals) completed a survey and 15 older people and carers were interviewed to produce 96 'unanswered questions'. These were further refined by survey and interviews to a shortlist of 21 topics, and a mix of people aged 80+ living with three or more conditions, carers and health and social care providers to prioritised the top 10.
the key priorities were about the prevention of social isolation, the promotion of independence and physical and emotional well-being. In addition to these broad topics, the process also identified detailed priorities including the role of exercise therapy, the importance of falls (particularly fear of falling), the recognition and management of frailty and Comprehensive Geriatric Assessment.
these topics provide a unique perspective on research priorities on multiple conditions in later life and complement existing UK and International recommendations about the optimisation of health and social care systems to deliver essential holistic models of care and the prevention and treatment of multiple co-existing conditions.
多种病症(多病共存)是全球卫生和保健系统面临的主要挑战,尤其与老年人相关,但直到最近,它才作为一个研究课题受到高度重视。我们采用詹姆斯·林德联盟优先事项设置伙伴关系的方法,从老年人、照护者和卫生与社会保健专业人员的角度确定了前 10 项研究重点。
共有 354 名参与者(162 名老年人及其照护者,192 名卫生专业人员)完成了一项调查,15 名老年人及其照护者接受了采访,提出了 96 个“未回答的问题”。这些问题通过调查和采访进一步提炼为 21 个主题的候选名单,由 80 岁以上、患有三种或更多疾病的人群、照护者以及卫生和社会保健提供者共同确定前 10 项重点。
重点是预防社交孤立、促进独立以及身体和情绪健康。除了这些广泛的主题外,该过程还确定了详细的优先事项,包括运动疗法的作用、跌倒(尤其是对跌倒的恐惧)的重要性、虚弱和全面老年评估的识别和管理。
这些主题为晚年多病共存的研究重点提供了独特的视角,并补充了英国和国际上关于优化卫生和保健系统以提供必要的整体护理模式以及预防和治疗多种共存疾病的现有建议。