Multimorbidity in primary care: protocol of a national cross-sectional study in Switzerland

Anouk Déruaz-Luyet; A Alexandra N'Goran; Ryan Tandjung; Peter Frey; Andreas Zeller; Dagmar M Haller; Thomas Rosemann; Bernard Burnand; Patrick Bodenmann; Nicolas Senn; Daniel Widmer; Lilli Herzig

doi:10.1136/bmjopen-2015-009165

Multimorbidity in primary care: protocol of a national cross-sectional study in Switzerland

BMJ Open. 2015 Oct 28;5(10):e009165. doi: 10.1136/bmjopen-2015-009165.

Authors

Affiliations

¹ Institute of Family Medicine, University of Lausanne, Lausanne, Vaud, Switzerland.
² Institute of Primary Care, University of Zürich, Zürich, Switzerland.
³ Institute of Primary Care at the University of Berne (BIHAM), University of Berne, Berne, Switzerland.
⁴ Centre for Primary Health Care, University of Basel, Basel, Switzerland.
⁵ Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
⁶ Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Vaud, Switzerland.
⁷ Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Vaud, Switzerland.

Abstract

Introduction: With the ageing of the population and the general improvement of care, an increasing number of people are living with multiple chronic health conditions or 'multimorbidity'. Multimorbidity often implies multiple medical treatments. As a consequence, the risk of adverse events and the time spent by patients for their treatments increase exponentially. In many cases, treatment guidelines traditionally defined for single conditions are not easily applicable. Primary care for individuals with multimorbidity requires complex patient-centred care and good communication between the patient and the general practitioner (GP). This often includes prioritising among the different chronic conditions.

Methods and analysis: The main objectives of this study are to describe the burden related to multimorbidity (disease-related burden and burden of treatment) in primary care and to identify the factors influencing it. Other objectives include evaluating patients' perception of treatment burden and quality of life, assessing factors influencing that perception, and investigating prioritisation in the management of multimorbidity from the perspectives of GPs and patients. For this cross-sectional study, patient enrolment will take place in GP's private practices across Switzerland. A convenient sample of 100 GPs will participate; overall, 1000 patients with at least three chronic health conditions will be enrolled. Data will be collected as paper-based questionnaires for GPs and delayed telephone interview questionnaires for patients. GPs will provide demographic and practice-related data. In addition, each GP will complete a paper-based questionnaire for each patient that they enrol. Each patient will complete a telephone interview questionnaire.

Ethics and dissemination: This study has been approved by the research ethics committee of Canton Vaud, Switzerland (Protocol 315/14). The results of the study will be reported in international peer-reviewed journals.

Keywords: PRIMARY CARE; chronic disease; cross-sectional study; multimorbidity; prioritization of care.

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Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Chronic Disease
Communication
Comorbidity*
Cost of Illness*
Cross-Sectional Studies
Disease Management*
General Practice*
General Practitioners
Humans
Patient-Centered Care
Physician-Patient Relations
Practice Patterns, Physicians'
Primary Health Care*
Research Design
Switzerland