Understanding patient outcomes to develop a multimorbidity adapted patient-reported outcomes measure: a qualitative description of patient and provider perspectives

Health Qual Life Outcomes. 2021 Feb 4;19(1):43. doi: 10.1186/s12955-021-01689-w.

Abstract

Background: Multimorbidity is a complex health situation that requires interventions tailored to patient needs; the outcomes of such interventions are difficult to evaluate. The purpose of this study was to describe the outcomes of patient-centred interventions for people with multimorbidity from the patients' and healthcare providers' perspectives.

Methods: This study followed a qualitative descriptive design. Nine patients with multimorbidity and 18 healthcare professionals (nurses, general practitioners, nutritionists, and physical and respiratory therapists), participating in a multimorbidity-adapted intervention in primary care were recruited. Data were collected using semi-structured interviews with 12 open-ended questions. Triangulation of disciplines among interviewers, research team debriefing, data saturation assessment and iterative data collection and analysis ensured a rigorous research process.

Results: Outcome constructs described by participants covered a wide range of themes and were grouped into seven outcome domains: Health Management, Physical Health, Functional Status, Psychosocial Health, Health-related Behaviours, General Health and Health Services. The description of constructs by stakeholders provides valuable insight on how outcomes are experienced and worded by patients.

Conclusion: Participants described a wide range of outcome constructs, which were relevant to and observable by patients and were in line with the clinical reality. The description provides a portrait of multimorbidity-adapted intervention outcomes that are significant for the selection and development of clinical research outcome measures.

Keywords: Chronic diseases; Multimorbidity; Patient-centred care; Patient-reported outcomes; Qualitative description; Self-management.

MeSH terms

  • Adult
  • Chronic Disease / therapy*
  • Female
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Multimorbidity*
  • Outcome Assessment, Health Care
  • Patient Reported Outcome Measures*
  • Patient-Centered Care / methods*
  • Primary Health Care / methods*
  • Qualitative Research
  • Quality of Life