Evidence map›Paper›PMID 28143412›Full record

ArticleBMC geriatrics2017

Managing multiple chronic conditions in the community: a Canadian qualitative study of the experiences of older adults, family caregivers and healthcare providers.

Jenny Ploeg, Nancy Matthew-Maich, Kimberly Fraser, Sinéad Dufour, Carrie McAiney, Sharon Kaasalainen, Maureen Markle-Reid, Ross Upshur, Laura Cleghorn, Anna Emili

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In one paragraph

Article in BMC geriatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
104citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

104 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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44 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jenny PloegAging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, HSc3N25C, Hamilton, ON, L8S 4K1, Canada. ploegj@mcmaster.ca.ORCID 0000-0001-8168-8449
Nancy Matthew-MaichHealth Science Research and Innovation, School of Nursing, Mohawk College of Applied Arts and Technology, 1400 Main Street West, IAHS - 354, Hamilton, ON, L8S 1C7, Canada.
Kimberly FraserFaculty of Nursing, University of Alberta, 5-185 Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
Sinéad DufourSchool of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, IAHS Rm 403, Hamilton, ON, L8S 4K1, Canada.
Carrie McAineyDepartment of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, 100 West 5th Street, Room G102, Hamilton, ON, L8N 3K7, Canada.
Sharon KaasalainenSchool of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
Maureen Markle-ReidAging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, HSc3N25C, Hamilton, ON, L8S 4K1, Canada.
Ross UpshurDepartment of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, M.33 1 Bridgepoint Drive, Toronto, ON, M4M 2B5, Canada.
Laura CleghornSchool of Nursing and Department of Family Medicine, Health TAPESTRY, McMaster University, 1280 Main Street West, David Braley Health Science Centre, 5th Floor, Hamilton, ON, L9S 4K1, Canada.
Anna EmiliMcMaster University, Main West Medical Group, 1685 Main Street West, Hamilton, ON, L8S 1G5, Canada.

Funding

CIHR TTF 128261
6 · The paper itself

Abstract

backgroundThe prevalence of multiple chronic conditions (MCC) among older persons is increasing worldwide and is associated with poor health status and high rates of healthcare utilization and costs. Current health and social services are not addressing the complex needs of this group or their family caregivers. A better understanding of the experience of MCC from multiple perspectives is needed to improve the approach to care for this vulnerable group. However, the experience of MCC has not been explored with a broad sample of community-living older adults, family caregivers and healthcare providers. The purpose of this study was to explore the experience of managing MCC in the community from the perspectives of older adults with MCC, family caregivers and healthcare providers working in a variety of settings.

methodsUsing Thorne's interpretive description approach, semi-structured interviews (n = 130) were conducted in two Canadian provinces with 41 community-living older adults (aged 65 years and older) with three or more chronic conditions, 47 family caregivers (aged 18 years and older), and 42 healthcare providers working in various community settings. Healthcare providers represented various disciplines and settings. Interview transcripts were analyzed using Thorne's interpretive description approach.

resultsParticipants described the experience of managing MCC as: (a) overwhelming, draining and complicated, (b) organizing pills and appointments, (c) being split into pieces, (d) doing what the doctor says, (e) relying on family and friends, and (f) having difficulty getting outside help. These themes resonated with the emotional impact of MCC for all three groups of participants and the heavy reliance on family caregivers to support care in the home.

conclusionsThe experience of managing MCC in the community was one of high complexity, where there was a large gap between the needs of older adults and caregivers and the ability of health and social care systems to meet those needs. Healthcare for MCC was experienced as piecemeal and fragmented with little focus on the person and family as a whole. These findings provide a foundation for the design of care processes to more optimally address the needs-service gap that is integral to the experience of managing MCC.

Indexed as

Qualitative ResearchAgedAged, 80 and overCanadaCaregiversChronic DiseaseDisease ManagementFemaleHealth PersonnelHumansIndependent LivingMaleMultiple Chronic ConditionsCaregiversHealthcare providersHome careMultimorbidityOlder personsPrimary careQualitative research

Identifiers

PMID28143412
PMCPMC5282921

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.