A multidisciplinary approach for patients with multiple chronic conditions: IMPACTO study

Nieto-Martín, Maria Dolores; Higuera-Vila, L. de la; Bernabéu-Wittel, Máximo; González-Benitez, Maria Angeles; Alfaro-Lara, Eva Rocío; Barón-Ramos, Miguel Angel; Montero-Aparicio, Esperanza; Aparicio-Santos, Reyes; Baturone, Manuel Ollero; Martin, Mike; Wittel, Máximo Bernabéu; Benítez, Ángeles González; Ramos, Miguel Ángel Barón; Sanz, María del Val Martín; Ocaña, Javier; Morano, Juan Santos; Vila, Laura De la Higuera; Montero, Esperanza; Torres, Miguel Angel Díaz; Santos, Reyes Aparicio; Jiménez, María Maiz; Gómez, Manuel Asensio; Quiles, Carlos Hernández; Gómez, Carlos Palacios; García, José Alejandro Medina; Baturone, M.O.; Giraldo, Diana Mendoza; González, Carmen Aguilera; Ojeda, Rocío Fernández; Machín, José Manuel; Gaviño, Lourdes Moreno; Zafra, A Ruz; Sanchez, Guarionex Uribarri; Costa, Mariela Grana; Bailón, Manuel Méndez; Juliá, Aránzazu Pereira; Cobas, Carla Rivas; Vaz, Antonio Javier Vallejo; Navarro, Antonio José; Rey, Jordi Forteza; Ferrer, Natalia Teresa Costa; Segovia, Julia Praena; Arraigosa, Antonio Albarracín; Murcia, José; Amado, Carolina Luque; Contreras, José Antonio Cuello; Guerrero, Monserrat Godoy; Fuentes, Daniel Vicente; Lara, Eva Alfaro; Coca, M Dolores Vega; Galván-Banqueri, Mercedes; Moyano, Antonio Fernández; Ruiz-Cantero, Alberto; Santos-Ramos, Bernardo

doi:10.1016/j.medcli.2019.01.014

Cited by 6 publications

(1 citation statement)

References 24 publications

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“…Multimorbidity is defined as the presence of two or more, generally chronic, illnesses in one person [ 1 , 2 ]. The prevalence of multimorbidity in General Practice- as well as in hospitalized patients is high and will most likely continue to increase over the next years [ 3 ]. In order to archive optimal care for multimorbid patients, an interdisciplinary approach using the expertise of more than one medical specialty can be helpful.…”

Section: Introductionmentioning

confidence: 99%

Asking the generalist – evaluation of a General Practice rounding and consult service

Schmalstieg-Bahr,

MacDonald,

Pohontsch

et al. 2024

BMC Prim. Care

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Background Vascular surgery patients admitted to the hospital are often multimorbid. In case of questions regarding chronic medical problems different specialties are consulted, which leads to a high number of treating physicians and possibly contradicting recommendations. The General Practitioner´s (GP) view could minimize this problem. However, it is unknown for which medical problems a GP would be consulted and if regular GP-involvement during rounds would be considered helpful by the specialists. The aim of this study was to establish and describe a General Practice rounding service (GP-RS), to evaluate if the GP-RS is doable in a tertiary care hospital and beneficial to the specialists and to explore GP-consult indications. Methods The GP-RS was established as a pilot project. Between June-December 2020, a board-certified GP from the Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf (UKE) joined the vascular surgery team (UKE) once-weekly on rounds. The project was evaluated using a multi-methods approach: semi-structured qualitative interviews were conducted with vascular surgery physicians that had either participated in the GP-RS (G1), had not participated (G2), other specialists usually conducting consults on the vascular surgery floor (G3) and with the involved GP (G4). Interviews were analyzed using Kuckartz’ qualitative content analysis. In addition, two sets of quantitative data were descriptively analyzed focusing on the reasons for a GP-consult: one set from the GP-RS and one from an established, conventional “as needed” GP-consult service. Results 15 interviews were conducted. Physicians perceived the GP-RS as beneficial, especially for surgical patients (G1-3). Optimizing medication, avoiding unnecessary consults and a learning effect for physicians in training (G1-4) were named as other benefits. Critical voices saw an increased workload through the GP-RS (G1, G3) and some consult requests as too specific for a GP (G1-3). Based on data from 367 vascular surgery patients and 80 conventional GP-consults, the most common reasons for a GP-consult were cardiovascular diseases including hypertension and diabetes. Conclusions A GP-RS is doable in a tertiary care hospital. Studies of GP co-management model with closer follow ups would be needed to objectively improve patient care and reduce the overall number of consults. Trial registration Not applicable.

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Section: Introductionmentioning

confidence: 99%