Investigating the needs and concerns of older adults with multimorbidity and their healthcare professionals for conceivable digital psychotherapeutic interventions

Abstract

Multimorbidity, defined as the concurrent experience of more than one chronic health condition in an individual, affects ∼65% of people over 65 and 85% of those over 85 years old with 30% of those also experiencing mental health concerns. This can lead to reduced quality of life and functioning as well as poorer outcomes in terms of condition management, adherence to treatment, and ultimately disease prognosis and progression. Digital health interventions offer a viable means of condition self-management, as well as psychological support, particularly for those who may have difficulty accessing in-person services. To best meet the needs of older adults with multimorbidity, deeper insights are needed into their specific concerns and issues around condition management, particularly with regard to distress in relation to managing one's condition. The present study aimed to explore this using one-to-one qualitative interviews and focus groups with people with chronic health conditions and healthcare professionals. Participants were 11 older adults with multimorbidity (4 males; mean age: M = 72.7 years) and 14 healthcare professionals including five clinical nurse specialists, four pharmacists, two general practitioners, one occupational therapist, one speech and language therapist and one dietician. Thematic analysis was used to identify key themes, which included: patient feelings of anxiety or worry leading to an unwillingness to access essential information; the various mental health challenges faced by those with multimorbidity; the importance of personal values in providing motivation; and the importance of social support. Findings are discussed in relation to the potential development of transdiagnostically applicable digital interventions for the management of distress in those with multimorbidity.

Decomposing the rural–urban differences in depression among multimorbid older patients in India: evidence from a cross-sectional study

“…Clinicians should consider the mental health of older patients especially women and oldest people when managing multimorbidity and provide immediate psychological assistance. Also, it is important to ensure that older adults with multimorbidity have access to an affordable treatment, especially in rural areas, which can significantly enhance their physical and mental well-being [ 45 ].…”

Technologies for Managing the Health of Older Adults with Multiple Chronic Conditions: A Systematic Literature Review

“…Patients must handle a large amount of information about each condition and represent their own interests [13], as well as be aware of any potential interactions between their conditions or between their medications. Furthermore, patients with multimorbidity may feel anxiety and distress towards their conditions, and sometimes cope through avoidance [14] so there may be challenging barriers to provide treatment as well as to implement interventions to support them.…”