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A Methodological Approach for Implementing an Integrated Multimorbidity Care Model: Results from the Pre-Implementation Stage of Joint Action CHRODIS-PLUS

Author

Listed:
  • Katie Palmer

    (Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00136 Rome, Italy)

  • Angelo Carfì

    (Centro di Medicina dell’Invecchiamento, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00136 Rome, Italy)

  • Carmen Angioletti

    (Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore and Centro di Medicina dell’Invecchiamento, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00136 Rome, Italy)

  • Antonella Di Paola

    (Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00136 Rome, Italy)

  • Rokas Navickas

    (Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
    Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania)

  • Laimis Dambrauskas

    (Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
    Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania)

  • Elena Jureviciene

    (Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
    Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania)

  • Maria João Forjaz

    (National School of Public Health and REDISSEC, Carlos III Institute of Health, ES-28029 Madrid, Spain)

  • Carmen Rodriguez-Blazquez

    (National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, ES-28029 Madrid, Spain)

  • Alexandra Prados-Torres

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, REDISSEC, 50009 Zaragoza, Spain)

  • Antonio Gimeno-Miguel

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, REDISSEC, 50009 Zaragoza, Spain)

  • Mabel Cano-del Pozo

    (General Directorate of Healthcare, Health Department, 50017 Zaragoza, Spain)

  • María Bestué-Cardiel

    (General Directorate of Healthcare, Health Department, 50017 Zaragoza, Spain)

  • Francisca Leiva-Fernández

    (Málaga-Guadalhorce Primary Care Teaching Unit, IBIMA, Andalusian Health Service, 29009 Málaga, Spain)

  • Elisa Poses Ferrer

    (Agency for Health Quality and Assessment of Catalonia (AQuAS), Government of Catalonia, 08005 Barcelona, Spain)

  • Ana M Carriazo

    (Regional Ministry of Health and Families of Andalusia (CSFJA), E-41020 Seville, Spain)

  • Carmen Lama

    (Regional Ministry of Health and Families of Andalusia (CSFJA), E-41020 Seville, Spain)

  • Rafael Rodríguez-Acuña

    (Andalusian Public Foundation Progress and Health (FPS), E-41092 Seville, Spain)

  • Inmaculada Cosano

    (San José de la Rinconada-Los Carteros Primary Care Center, Andalusian Health Service (Servicio Andaluz de Salud, SAS), E-41300 Seville, Spain)

  • Juan José Bedoya-Belmonte

    (Tiro de Pichón Primary Care Center, Andalusian Health Service (Servicio Andaluz de Salud, SAS), E-29006 Málaga, Spain)

  • Ida Liseckiene

    (Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania)

  • Mirca Barbolini

    (European Commission (DG Santè), 41225 Modena, Italy)

  • Jon Txarramendieta

    (Kronikgune Institute for Health Services Research, 48902 Basque Country, Spain)

  • Esteban de Manuel Keenoy

    (Kronikgune Institute for Health Services Research, 48902 Basque Country, Spain)

  • Ane Fullaondo

    (Kronikgune Institute for Health Services Research, 48902 Basque Country, Spain)

  • Mieke Rijken

    (Nivel (Netherlands Institute for Health Services Research), 3513 CR Utrecht, The Netherlands
    Department of Health and Social Management, University of Eastern Finland, FI-70210 Kuopio, Finland)

  • Graziano Onder

    (Department of Cardiovascular, Metabolic and Aging Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy)

Abstract

Patients with multimorbidity (defined as the co-occurrence of multiple chronic diseases) frequently experience fragmented care, which increases the risk of negative outcomes. A recently proposed Integrated Multimorbidity Care Model aims to overcome many issues related to fragmented care. In the context of Joint Action CHRODIS-PLUS, an implementation methodology was developed for the care model, which is being piloted in five sites. We aim to (1) explain the methodology used to implement the care model and (2) describe how the pilot sites have adapted and applied the proposed methodology. The model is being implemented in Spain (Andalusia and Aragon), Lithuania (Vilnius and Kaunas), and Italy (Rome). Local implementation working groups at each site adapted the model to local needs, goals, and resources using the same methodological steps: (1) Scope analysis; (2) situation analysis—“strengths, weaknesses, opportunities, threats” (SWOT) analysis; (3) development and improvement of implementation methodology; and (4) final development of an action plan. This common implementation strategy shows how care models can be adapted according to local and regional specificities. Analysis of the common key outcome indicators at the post-implementation phase will help to demonstrate the clinical effectiveness, as well as highlight any difficulties in adapting a common Integrated Multimorbidity Care Model in different countries and clinical settings.

Suggested Citation

  • Katie Palmer & Angelo Carfì & Carmen Angioletti & Antonella Di Paola & Rokas Navickas & Laimis Dambrauskas & Elena Jureviciene & Maria João Forjaz & Carmen Rodriguez-Blazquez & Alexandra Prados-Torres, 2019. "A Methodological Approach for Implementing an Integrated Multimorbidity Care Model: Results from the Pre-Implementation Stage of Joint Action CHRODIS-PLUS," IJERPH, MDPI, vol. 16(24), pages 1-18, December.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:24:p:5044-:d:296510
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    References listed on IDEAS

    as
    1. Palmer, Katie & Marengoni, Alessandra & Forjaz, Maria João & Jureviciene, Elena & Laatikainen, Tiina & Mammarella, Federica & Muth, Christiane & Navickas, Rokas & Prados-Torres, Alexandra & Rijken, Mi, 2018. "Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS)," Health Policy, Elsevier, vol. 122(1), pages 4-11.
    2. Hopman, Petra & de Bruin, Simone R. & Forjaz, Maria João & Rodriguez-Blazquez, Carmen & Tonnara, Giuseppe & Lemmens, Lidwien C. & Onder, Graziano & Baan, Caroline A. & Rijken, Mieke, 2016. "Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review," Health Policy, Elsevier, vol. 120(7), pages 818-832.
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    1. Teodora Figueiredo & Luís Midão & Rute Sampaio & Joana Carrilho & Constantino Coelho & Giovanni Cerullo & Antonella Di Paola & Angelo Carfì & Graziano Onder & Elísio Costa, 2023. "Managing Non-Cancer Chronic Pain in Frail Older Adults: A Pilot Study Based on a Multidisciplinary Approach," IJERPH, MDPI, vol. 20(24), pages 1-9, December.
    2. Maria João Forjaz & Carmen Rodriguez-Blazquez & Inmaculada Guerrero-Fernández de Alba & Antonio Gimeno-Miguel & Kevin Bliek-Bueno & Alexandra Prados-Torres & on behalf of the CHRODIS Expert Group on M, 2019. "Application of the JA-CHRODIS Integrated Multimorbidity Care Model (IMCM) to a Case Study of Diabetes and Mental Health," IJERPH, MDPI, vol. 16(24), pages 1-13, December.
    3. Andrew Barnfield & Nella Savolainen & Anne Lounamaa, 2020. "Health Promotion Interventions: Lessons from the Transfer of Good Practices in CHRODIS-PLUS," IJERPH, MDPI, vol. 17(4), pages 1-14, February.
    4. Ignatios Ioakeim-Skoufa & Mercedes Clerencia-Sierra & Aida Moreno-Juste & Carmen Elías de Molins Peña & Beatriz Poblador-Plou & Mercedes Aza-Pascual-Salcedo & Francisca González-Rubio & Alexandra Prad, 2022. "Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort," IJERPH, MDPI, vol. 19(16), pages 1-15, August.
    5. Francisco Ruiz-Dominguez & Ingrid Stegeman & Javier Dolz-López & Lina Papartyte & Dolores Fernández-Pérez, 2021. "Transfer and Implementation Process of a Good Practice in Workplace Health Promotion," IJERPH, MDPI, vol. 18(10), pages 1-17, May.
    6. Jia Feng & Xiao-min Mu & Ling-ling Ma & Wei Wang, 2020. "Comorbidity Patterns of Older Lung Cancer Patients in Northeast China: An Association Rules Analysis Based on Electronic Medical Records," IJERPH, MDPI, vol. 17(23), pages 1-13, December.
    7. Carmen Rodriguez-Blazquez & Maria João Forjaz & Antonio Gimeno-Miguel & Kevin Bliek-Bueno & Beatriz Poblador-Plou & Sara Pilar Luengo-Broto & Inmaculada Guerrero-Fernández de Alba & Ana Maria Carriazo, 2020. "Assessing the Pilot Implementation of the Integrated Multimorbidity Care Model in Five European Settings: Results from the Joint Action CHRODIS-PLUS," IJERPH, MDPI, vol. 17(15), pages 1-14, July.
    8. Ignatios Ioakeim-Skoufa & Beatriz Poblador-Plou & Jonás Carmona-Pírez & Jesús Díez-Manglano & Rokas Navickas & Luis Andrés Gimeno-Feliu & Francisca González-Rubio & Elena Jureviciene & Laimis Dambraus, 2020. "Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study," IJERPH, MDPI, vol. 17(12), pages 1-15, June.

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