#WeStNs - Wednesday 23rd June 2021 8pm (GMT Standard Time) Nursing Patients With Multiple Health Needs

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The number of patients with more than one long-term health condition (often referred to as multimorbidity) is on the increase worldwide (The Academy of Medical Sciences, 2018).Whilst being almost universal in older populations (NICE, 2018) it is also increasing in younger populations (The Academy of Medical Sciences, 2018). 

A number of issues come with have multiple long-term conditions. Patients are more likely to experience lower quality of life, premature death, have higher need fo rhealthcare services, and have increased chances of disability and mental health problems (The Richmond Group of Charities, 2018; NICE, 2018; The Academy of Medical Sciences, 2018). They are likely to experience poorer medicine management and polypharmacy (The Richmond Group of Charities, 2018). They are also more prone to developing further health problems (WHO, 2016; NICE, 2018).Safety incidents, including adverse drug effects, are also more common for these patients (NICE, 2018; WHO, 2019). Multiple health conditions are also more prevalent in areas of lower socio-economic status, especially with younger patients, and where mental health conditions exist (The Richmond Group of Charities, 2018. Bramley and Moody, 2016).

Despite this health services, especially in secondary care, are often focussed on specific illnesses or groups of illness (Navickas et al, 2016), and guidelines are written with this in mind (WHO, 2019. NICE, 2009). This means that patients are likely to be under multiple health teams who may not always understand the complexity of their health needs. Patients express that they often feel that communication is poor between these teams, and that different teams may have differing opinions on how a patient should be treated (Navickas et al, 2016).It may also be important for patients that their care looks at their own preferences and needs (Ryley,2019), involves education, and involves their families as appropriate(Kulpers, Nieboer and Cramm, 2021)

Discussion:

Focused themes include:

  1. What do you think are the primary care needs of patients with multiple health conditions?
  2. What sort of barriers do you think patients with multiple health needs may face when seeking care?
  3. How do you think co-ordination of care between different specialties can be managed differently when it comes to patients with multiple health needs?
  4. How do you think we can make sure that patients are have their voices heard and can make their own decisions there are many health professionals involved?
  5. Have you seen any demonstrations of good practice when caring for patients with multiple health conditions?
  6. How do you think care for patients with multiple health conditions can be improved in secondary care?

Further Reading:

The Academy of Medical Health Sciences (2018)‘Multimorbidity: A Priority for Global Health Research’ available at https://acmedsci.ac.uk/file-download/82222577

Kuipers, S.J; Nieboaer, A.P; and Cramm, J.M(2021) ‘Making Care More Patient Centred; Experiences of HealthcareProfessionals and Patients With Multimorbidity in Primary Care Setting’ BMCFamily Practice, 22 (70) DOI 10.1186/s12875-021-01420-0

Navickas, R., Petric, V., Feigl, A.B. and Seychell, M. (2016) 'Multimorbidity:What do we know? What should we do?', Journal of Comorbidity, 6(1), pp. 4-11.

NICE(2018) Multimorbidity |CKS. Available at: https://cks.nice.org.uk/topics/multimorbidity/ 

NICE(2009) Medicines adherence:involving patients in decisions about prescribed medicines and supportingadherence [CG76]. Available at: https://www.nice.org.uk/guidance/CG76 

TheRichmond Group of Charities (2018) ‘Multimorbidity: Understanding theChallenge’ available at: https://richmondgroupofcharities.org.uk/sites/default/files/multimorbidity_-_understanding_the_challenge.pdf

Ryley,K. (2019) ‘Living with multipleconditions: Health and Care services can’t make me “better”, but they can bebetter for people like me?’ Available at: https://richmondgroupofcharities.org.uk/news/living-multiple-conditions-health-and-care-services-can%E2%80%99t-make-me-%E2%80%9Cbetter%E2%80%9D-they-can-be-better

WHO (2019) Medication Safety inPolypharmacy. Available at: https://apps.who.int/iris/handle/10665/325454 

WHO(2016) Multimorbidity: Technical Series on Safer Primary Care. Avaliable at https://apps.who.int/iris/bitstream/handle/10665/252275/9789241511650-eng.pdf?sequence=1


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