Evidence map›Paper›PMID 29776442›Full record

ArticleBMC family practice2018

Multimorbidity: can general practitioners identify the health conditions most important to their patients? Results from a national cross-sectional study in Switzerland.

Anouk Déruaz-Luyet, Alexandra A N'Goran, Jérôme Pasquier, Bernard Burnand, Patrick Bodenmann, Stefan Zechmann, Stefan Neuner-Jehle, Nicolas Senn, Daniel Widmer, Sven Streit and 3 more

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In one paragraph

Article in BMC family practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
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

13 authors.

Anouk Déruaz-LuyetInstitute of Family Medicine, University of Lausanne, 44 rue du Bugnon, 1011, Lausanne, Switzerland.
Alexandra A N'GoranInstitute of Family Medicine, University of Lausanne, 44 rue du Bugnon, 1011, Lausanne, Switzerland.
Jérôme PasquierInstitute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Bernard BurnandInstitute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Patrick BodenmannDepartment of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Stefan ZechmannInstitute of Primary Care, University of Zurich, Zurich, Switzerland.
Stefan Neuner-JehleInstitute of Primary Care, University of Zurich, Zurich, Switzerland.
Nicolas SennInstitute of Family Medicine, University of Lausanne, 44 rue du Bugnon, 1011, Lausanne, Switzerland.
Daniel WidmerInstitute of Family Medicine, University of Lausanne, 44 rue du Bugnon, 1011, Lausanne, Switzerland.
Sven StreitInstitute of Primary Health Care (BIHAM), University of Berne, Berne, Switzerland.
Andreas ZellerCentre for Primary Health Care, University of Basel, Basel, Switzerland.
Dagmar M HallerPrimary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Lilli HerzigInstitute of Family Medicine, University of Lausanne, 44 rue du Bugnon, 1011, Lausanne, Switzerland. Lilli.herzig@hin.ch.ORCID 0000-0003-0025-3449

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFaced with patients suffering from more than one chronic condition, or multimorbidity, general practitioners (GPs) must establish diagnostic and treatment priorities. Patients also set their own priorities to handle the everyday burdens associated with their multimorbidity and these may be different from the priorities established by their GP. A shared patient-GP agenda, driven by knowledge of each other's priorities, would seem central to managing patients with multimorbidity. We evaluated GPs' ability to identify the health condition most important to their patients.

methodsData on 888 patients were collected as part of a cross-sectional Swiss study on multimorbidity in family medicine. For the main analyses on patients-GP agreement, data from 572 of these patients could be included. GPs were asked to identify the two conditions which their patient considered most important, and we tested whether either of them agreed with the condition mentioned as most important by the patient. In the main analysis, we studied the agreement rate between GPs and patients by grouping items medically-related into 46 groups of conditions. Socio-demographic and clinical variables were fitted into univariate and multivariate models.

resultsIn 54.9% of cases, GPs were able to identify the health condition most important to the patient. In the multivariate model, the only variable significantly associated with patient-GP agreement was the number of chronic conditions: the higher the number of conditions, the less likely the agreement.

conclusionGPs were able to correctly identify the health condition most important to their patients in half of the cases. It therefore seems important that GPs learn how to better adapt treatment targets and priorities by taking patients' perspectives into account.

Indexed as

Cost of IllnessGeneral PractitionersMultimorbidityPhysician-Patient RelationsAdultAgedAttitude of Health PersonnelAttitude to HealthCross-Sectional StudiesFemaleGeneral PracticeHumansMaleMiddle AgedPatient Care ManagementPatient PreferenceFamily medicineMultimorbidityPatient–provider agreement

Identifiers

PMID29776442
PMCPMC5960174

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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.