Article type
Abstract
Background: Multimorbidity is a growing global health concern that also poses new challenges for the development and use of clinical practice guidelines (CPGs). Most CPGs focus on 1 target condition with limited additional guidance for patients with comorbidities. Some institutions such as NICE have developed health-centered multimorbidity guidelines, and there exist guidelines for specific disease combinations (eg, hypertension with diabetes). Clinicians must therefore often refer to multiple guidelines in the management of patients with multimorbidity, and making the optimal clinical decisions can be challenging.
Objectives: Our project aims to formulate a guideline-based decision support framework for clinical practice in patients with multimorbidity. The framework will help clinicians evaluate and choose recommendations from guidelines related to the different conditions and aspects efficiently.
Methods: The framework will be developed in 5 steps. First, we will conduct a systematic review of current health- and disease-centered multimorbidity guidelines. Second, we will conduct a questionnaire survey among people with experience in multimorbidity management and invite selected experts for an interview to explore the adherence to, and use of, guidelines in multimorbidity-related clinical practice. Third, we will review the current guideline-based clinical decision support systems to collect the characteristics of such systems and the shortcomings of their application for multimorbidity. Fourth, based on the findings from the first 3 steps, we will formulate a clinical decision support framework. We will conduct 2 rounds of Delphi survey with an expert panel, revise and polish the system based on the feedback, and formulate the final version. Fifth, we will invite clinicians to test the framework in real practice and provide feedback for future updates.
Results: At the Summit, we will present, in addition to the protocol, preliminary results from the first steps of the project.
Conclusions and relevance and importance to patients: The decision support system will help health providers to use different guidelines efficiently when making decisions related to the care of patients with multimorbidity. Our system can reduce the interactions between conditions and drugs and lead the way to a patient-centered approach to manage the increasingly complex and heterogeneous health issues in patients with multimorbidity.
Objectives: Our project aims to formulate a guideline-based decision support framework for clinical practice in patients with multimorbidity. The framework will help clinicians evaluate and choose recommendations from guidelines related to the different conditions and aspects efficiently.
Methods: The framework will be developed in 5 steps. First, we will conduct a systematic review of current health- and disease-centered multimorbidity guidelines. Second, we will conduct a questionnaire survey among people with experience in multimorbidity management and invite selected experts for an interview to explore the adherence to, and use of, guidelines in multimorbidity-related clinical practice. Third, we will review the current guideline-based clinical decision support systems to collect the characteristics of such systems and the shortcomings of their application for multimorbidity. Fourth, based on the findings from the first 3 steps, we will formulate a clinical decision support framework. We will conduct 2 rounds of Delphi survey with an expert panel, revise and polish the system based on the feedback, and formulate the final version. Fifth, we will invite clinicians to test the framework in real practice and provide feedback for future updates.
Results: At the Summit, we will present, in addition to the protocol, preliminary results from the first steps of the project.
Conclusions and relevance and importance to patients: The decision support system will help health providers to use different guidelines efficiently when making decisions related to the care of patients with multimorbidity. Our system can reduce the interactions between conditions and drugs and lead the way to a patient-centered approach to manage the increasingly complex and heterogeneous health issues in patients with multimorbidity.