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Improvements to healthcare needed to manage multimorbidity

Improvements to healthcare system needed to manage multimorbidity

Living with multiple health conditions, such as heart disease and diabetes, is a challenge for increasing numbers of New Zealanders. New research led by the University of Otago, Wellington, has identified issues and improvements needed in the health care system to help patients with multimorbidity (multiple health conditions), their supporters and health care providers.

The views of people living with multmorbidity were reported in a study published in this week’sNew Zealand Medical Journal, and funded by the Health Research Council of New Zealand.

The researchers talked with 61 people about what it is like to live with multimorbidity.

Living with multimorbidity is both disruptive and challenging for many people in their 'normal' lives, however many learn to manage and cope with help, says one of the researchers Jeannine Stairmand from the University of Otago, Wellington.

As one man told the researchers “it’s a bad look with the walking stick in one hand and a chainsaw in the other, but I still get work done.”

Patients often described feeling overwhelmed by having numerous health services to access, different health professionals to see and multiple medications to take. The complexity of multimorbidity does not fit naturally within a healthcare system that is “siloed” by single diseases.This research suggests that changes are needed to the way in which healthcare is organised and delivered in order to meet the complex needs of multi-morbid patients.

The study found that people with multimorbidity require more help to manage the many medications they are prescribed and their resulting side effects.

“Some people who were on multiple medications had to cut down or leave work as the medications would make them fall asleep,” says Ms Stairmand.

“People really value simple things like good communication, having enough time to discuss their issues with a regular doctor. We found that respectful care was hugely important and made a big difference,” she says.

Nearly all participants spoke of needing care and support from family and friends to manage their health. Māori and migrant participants expressed the need for holistic and culturally competent health services. This could be achieved through an increased focus on cultural competence in healthcare training, including immersion at an early stage, and an increased indigenous workforce. A significant increase in Māori medical graduates from the University of Otago bodes well.


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