Managing long-term conditions (such as diabetes or heart disease) is a big part of the work of primary care. Services in primary care currently focus on single conditions but many older people have more than one long-term condition - this is called multimorbidity.
Patients with multimorbidity are potentially vulnerable to safety failures because they can have complex healthcare needs and spend a lot of time interacting with healthcare services. Older patients especially may also face barriers to their capacity to deal with the demands of managing their conditions.
There is a real need to better understand the biggest safety issues faced by patients with multimorbidity, and to develop ways to help reduce their vulnerability to safety failures.
The aim of this theme is to identify, develop and evaluate patient- and carer-oriented interventions to minimise safety failures in patients with multimorbidity.
We started out by:
- Identifying threats to patient safety in primary care through a meta-synthesis of qualitative studies
- Examining the relationship between multimorbidity and patient safety, and identifying groups of patients with multimorbidity that are most at risk from safety failures through a systematic review and meta-analysis
We are in the process of:
- Exploring the contribution of patients with multimorbidity, their carers and primary healthcare providers to monitoring safety and reducing the impact of safety failures through the MAXIMUM study
- Developing and evaluating interventions (including case management) to modify care delivery to ensure that key threats to safety in patients with multimorbidity are reduced
We will go on to:
- Test the ease of implementation of interventions in routine NHS settings and their effects on safety, outcomes and costs
- Ensure that patient safety issues arising from multimorbidity are integral to future policy around the management of long-term conditions
Find out more about our Multimorbidity research in the Multimorbidity Information Sheet (pdf) or the Centre for Primary Care Multimorbidity Research leaflet (pdf)
Working with colleagues from the Universities of Oxford and Nottingham, we have spoken to people living with multimorbidity about the challenges they experience. We are sharing what we have learned with other patients, carers, and healthcare providers through healthtalk.org - find out more in our case study on the Healthtalk module.
Patient and Public Involvement (PPI)
We have had a lot of help and advice from past and present members of the Greater Manchester PSTRC Research User Group (RUG). You can find out more about our RUG members’ involvement in the MAXIMUM PPI case study (pdf)
In 2015, we set up the Multimorbidity Research Advisory Group (MRAG) to help us better understand the views of patients and carers and involve them in the development of interventions and new research projects. For more information see the:
- Video of our first meeting - Primary care patient safety
- Video from our second meeting – Patient involvement in healthcare and safety
We also obtained external funding from the NIHR School for Primary Care Research to involve patients, carers and healthcare professionals, in shaping interventions to improve patient safety. In the Empowering People to Help Speak Up about Safety (EPHESUS) in Primary Care project we used a method called Accelerated Experience-Based Co-Design (AEBCD), which involves showing videos of patients talking about the issues that matter to them.
We raise awareness of our research and share what we are doing and what we have learned through:
- Our Twitter feed - @Multimorbidity
- The Greater Manchester PSTRC and
Blog posts from the Multimorbidity theme cover a range of topics, from integrated care to care.data. Of special interest is the series ‘The desperate fight to be heard, and supported, when living with the invisible struggles of Multimorbidity’ written by Max Scott, a person with lived experience of multimorbidity
|Name||Job title||Meet the Team||Email address||Contact number|
|Professor Peter Bower||Theme Leadfirstname.lastname@example.org||+44 (0)161 275 7638|
|Dr Gavin Daker-White||Research Fellow||Meet the Team email@example.com||+44 (0)161 275 7637|
|Rebecca Hays||Research Associate||Meet the Team firstname.lastname@example.org||+44 (0)161 275 0546|
|Sarah Croke||Research Associateemail@example.com||-|