ArticleFamily medicine and community health2021
Multimorbidity and clinical reasoning through the eyes of GPs: a qualitative study.
Article in Family medicine and community health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Community pharmacists' practices and clinical reasoning towards hospital discharge prescription: a study using simulations and retrospective think-aloud methodology.International journal of clinical pharmacy · 2026Article
- In Support of Meaningful Assessment and Feedback: A Study of Clinical Reasoning Tasks Used in Ambulatory Case Reviews.Perspectives on medical education · 2026Article
- Clinical decision fatigue: a systematic and scoping review with meta-synthesis.Family medicine and community health · 2025Article
- Clinical reasoning amongst paramedics using nebulised β₂ agonists to treat acute asthma exacerbations: a qualitative study.NPJ primary care respiratory medicine · 2024Article
- General practitioners' assessment and management of chronic kidney disease in older patients- a mixed methods study.BMC primary care · 2024Article
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7 authors.
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Abstract
objectivesDespite the high prevalence of patients suffering from multimorbidity, the clinical reasoning processes involved during the longitudinal management are still sparse.This study aimed to investigate what are the different characteristics of the clinical reasoning process clinicians use with patients suffering from multimorbidity, and to what extent this clinical reasoning differs from diagnostic reasoning.
designGiven the exploratory nature of this study and the difficulty general practitioners (GPs) have in expressing their reasoning, a qualitative methodology was therefore, chosen. The Clinical reasoning Model described by Charlin
settingSemistructured interviews were conducted with nine GPs working in an ambulatory setting in June to September 2018, in Geneva, Switzerland.
participantsParticipants were GPs who came from public hospital or private practice. The interviews were transcribed verbatim and a thematic analysis was conducted.
resultsThe results highlighted how some cognitive processes seem to be more specific to the management reasoning.Thus, the main goal is not to reach a diagnosis, but rather to consider several possibilities in order to maintain a balance between the evidence-based care options, patient's priorities and maintaining quality of life. The initial representation of the current problem seems to be more related to the importance of establishing links between the different pre-existing diseases, identifying opportunities for actions and trying to integrate the new elements from the patient's context, rather than identifying the signs and symptoms that can lead to generating new clinical hypotheses. The multiplicity of options to resolve problems is often perceived as difficult by GPs. Furthermore, longitudinal management does not allow them to achieve a final resolution of problems and that requires continuous review and an ongoing prioritisation process.
conclusionThis study contributes to a better understanding of the clinical reasoning processes of GPs in the longitudinal management of patients suffering from multimorbidity. Through a practical and accessible model, this qualitative study offers new perspectives for identifying the components of management reasoning. These results open the path to new research projects.
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