Fortin Martin, Stewart Moira, Almirall José, Berbiche Djamal, Bélanger Mathieu, Katz Alan, Ryan Bridget L, Wong Sabrina T, Zwarenstein Merrick
Université de Sherbrooke, Chicoutimi, QC, Canada.
Western University, London, ON, Canada.
J Multimorb Comorb. 2021 Nov 17;11:26335565211039780. doi: 10.1177/26335565211039780. eCollection 2021 Jan-Dec.
Interventions for people with multimorbidity have obtained mixed results. We aimed to document the long-term effect of an intervention for people with multimorbidity.
284 patients (18-80 years) presenting three or more chronic conditions were recruited from seven family medicine groups in the Saguenay-Lac St-Jean region, Quebec, Canada. The patient-centered intervention was based on motivational approach and self-management support. Outcomes were evaluated in a one-year pre-post study design with questionnaires that included the Health Education Questionnaire (heiQ), the Self-Efficacy for Managing Chronic Diseases, the Veteran RAND-12 Health Survey (VR-12), the EuroQoL 5-Domains questionnaire, the Kessler six item Psychological Stress Scale, and measures of smoking habit, physical activity, healthy eating and alcohol consumption. Subgroup analyses by age, number of conditions, sex, and income were also conducted.
The heiQ domain of emotional wellbeing improved significantly. Improvement was also observed for the VR-12 and the K6. Among the health behaviours, only healthy eating was improved. Subgroup analyses in this exploratory study suggest that younger patients, those with lower number of chronic conditions or higher incomes may respond better in relation to self-management, health status and health behaviours.
One year after the intervention, participants significantly improved a variety of outcomes. Subgroup analyses suggest that younger patients, those with lower number of chronic conditions or higher incomes may respond better in relation to self-management, health status and health behaviours. This suggests that future interventions should be tailored to patients' characteristics including age, sex, income and number of conditions.
针对患有多种疾病的人群的干预措施取得了喜忧参半的结果。我们旨在记录一项针对患有多种疾病的人群的干预措施的长期效果。
从加拿大魁北克省萨格奈 - 圣让湖地区的七个家庭医疗小组招募了284名患者（年龄在18 - 80岁之间），这些患者患有三种或更多种慢性病。以患者为中心的干预措施基于动机方法和自我管理支持。在一项为期一年的前后对照研究设计中，使用问卷对结果进行评估，问卷包括健康教育问卷（heiQ）、慢性病自我管理效能感、退伍军人兰德12项健康调查（VR - 12）、欧洲五维健康量表、凯斯勒六项心理压力量表，以及吸烟习惯、身体活动、健康饮食和饮酒情况的测量指标。还按年龄、疾病数量、性别和收入进行了亚组分析。
情绪健康的heiQ领域有显著改善。VR - 12和K6量表也有改善。在健康行为方面，只有健康饮食得到了改善。这项探索性研究中的亚组分析表明，年轻患者、慢性病数量较少或收入较高的患者在自我管理、健康状况和健康行为方面可能反应更好。
干预一年后，参与者在多种结果方面有显著改善。亚组分析表明，年轻患者、慢性病数量较少或收入较高的患者在自我管理、健康状况和健康行为方面可能反应更好。这表明未来的干预措施应根据患者的特征进行调整，包括年龄、性别、收入和疾病数量。
