Responding To Vulnerable Patients With Multimorbidity: An Interprofessional Team Approach

Abstract

\n Background\n\nPeople with multimorbidity, who may be more vulnerable, often require care by an interprofessional primary healthcare (PHC) team that can tailor their approach to address the multiple and complex needs of this population. This study explored how the needs of vulnerable patients experiencing multimorbidity receive care by innovative interprofessional PHC teams during a one-hour consultation, outside of usual care.\nMethods\n\nThis was a descriptive qualitative study. Forty-eight interviews were conducted with 20 allied healthcare professionals: (e.g., social work, pharmacy); 19 physicians (e.g., psychiatry, internal medicine, family medicine); and 9 decision makers. The thematic analysis was both iterative and interpretative using an individual and team approach to identify the main themes and exemplar quotations for illustration.\nResults\n\nParticipants described patients with multimorbidity who were vulnerable as those experiencing major challenges accessing and navigating the healthcare system. Mental health issues were a major contributor to being vulnerable and often linked to common social determinants of health. Cultural factors were identified as potentially causing patients to be vulnerable. Participants articulated how the collaborative nature of the team generated new ideas and facilitated creative recommendations designed to meet the specific needs of each patient.\nConclusions\n\nThis one-time consultation went beyond the assessment of a patient’s multimorbidity by including a psycho-social-contextual understanding of vulnerability within the healthcare system. Findings may have important clinical and policy implications in the adoption and implementation of this approach and further assist vulnerable patients with multimorbidity.