%0 Journal Article
%T Research on multimorbidity in primary care. Selected abstracts from the EGPRN meeting in Tampere, Finland, 9¨C12 May 2019
%J European Journal of General Practice
%D 2019
%R https://doi.org/10.1080/13814788.2019.1643166
%X Multimorbidity challenges existing healthcare organization and research, which remains disease and single-condition focused. Basic science approaches to multimorbidity have the potential to identify important shared mechanisms by which diseases we currently think of as distinct might arise, but there is a pressing need for more applied and health services research to understand better and manage multimorbidity now. There are several recent clinical guidelines, which make recommendations for managing multimorbidity or related issues for patients such as polypharmacy and frailty. However, the evidence base underpinning these recommendations is often weak, and these guidelines, therefore, also help define a research agenda. A key problem for researchers and health services is that multimorbidity is very heterogeneous, in that ¡®intermittent low back pain plus mild eczema¡¯ presents very different challenges to researchers and health services compared to ¡®active psychosis plus severe heart failure¡¯. Identifying important but tractable research questions is therefore not always straightforward. This presentation will identify important gaps in the evidence, and illustrate how they might be filled. The focus will be on two areas where there is consensus that better evidence is needed to inform care design and delivery: (1) organizational interventions to implement more coordinated and holistic care; and (2) interventions to improve medicines management in people with multimorbidity and polypharmacy. These illustrate both the potential for imaginative research, but also the scale. Current primary care in Finland is based on the Primary Health Care Act (1972), which addressed numerous new tasks to all municipalities. All of them had to find a new health centre organization, which provides a wide range of health services, including prevention and public health promotion. Multiple tasks require multiprofessional staff, and thus, the Finnish health centre personnel consisted not only of GPs but of public health nurses, midwives, physiotherapists, psychologists, social workers, dentists, etc. During the next decade, there have been some changes but the idea of multiprofessional structure has remained. According to the QUALICOPC study (2012) Finnish GPs are still co-located with several other healthcare professionals compared to most of the European countries; even compared to other Nordic countries which otherwise have many similarities in their primary healthcare. During the last 10 or 15 years, healthcare providers and researchers have recognized a new challenge:
%U https://www.tandfonline.com/doi/full/10.1080/13814788.2019.1643166