Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/31383
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: The development and optimisation of a primary care-based whole system complex intervention (CARE Plus) for patients with multimorbidity living in areas of high socioeconomic deprivation
Author(s): Mercer, Stewart William
O'Brien, Rosaleen
Fitzpatrick, Bridie
Higgins, Maria
Guthrie, Bruce
Watt, Graham
Wyke, Sally
Keywords: Primary care
multimorbidity
deprivation
complex intervention
quality of life
Issue Date: Sep-2016
Citation: Mercer SW, O'Brien R, Fitzpatrick B, Higgins M, Guthrie B, Watt G & Wyke S (2016) The development and optimisation of a primary care-based whole system complex intervention (CARE Plus) for patients with multimorbidity living in areas of high socioeconomic deprivation. Chronic Illness, 12 (3), pp. 165-181. https://doi.org/10.1177/1742395316644304
Abstract: Objectives: To develop and optimise a primary care-based complex intervention (CARE Plus) to enhance the quality of life of patients with multimorbidity in the deprived areas. Methods: Six co-design discussion groups involving 32 participants were held separately with multimorbid patients from the deprived areas, voluntary organisations, general practitioners and practice nurses working in the deprived areas. This was followed by piloting in two practices and further optimisation based on interviews with 11 general practitioners, 2 practice nurses and 6 participating multimorbid patients. Results: Participants endorsed the need for longer consultations, relational continuity and a holistic approach. All felt that training and support of the health care staff was important. Most participants welcomed the idea of additional self-management support, though some practitioners were dubious about whether patients would use it. The pilot study led to changes including a revised care plan, the inclusion of mindfulness-based stress reduction techniques in the support of practitioners and patients, and the stream-lining of the written self-management support material for patients. Discussion: We have co-designed and optimised an augmented primary care intervention involving a whole-system approach to enhance quality of life in multimorbid patients living in the deprived areas. CARE Plus will next be tested in a phase 2 cluster randomised controlled trial.
DOI Link: 10.1177/1742395316644304
Rights: This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). PMID: 27068113
Licence URL(s): http://creativecommons.org/licenses/by/3.0/

Files in This Item:
File Description SizeFormat 
ChronicIll2016.pdfFulltext - Published Version226.32 kBAdobe PDFView/Open



This item is protected by original copyright



A file in this item is licensed under a Creative Commons License Creative Commons

Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

If you believe that any material held in STORRE infringes copyright, please contact library@stir.ac.uk providing details and we will remove the Work from public display in STORRE and investigate your claim.