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Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study.
Behav Sci (Basel)
January 2025
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37073 Göttingen, Germany.
Multimorbidity poses significant challenges for patients and healthcare systems, often exacerbated by fragmented care and insufficient collaboration across providers. Blended Collaborative Care (BCC) is a promising strategy to address care complexity by partnering care managers (CMs) with primary care providers (PCPs) and specialists. This study aimed to adapt and pilot a BCC intervention for patients aged 65+ with heart failure and physical-mental multimorbidity.
View Article and Find Full Text PDFMinimising harms of tight glycaemic control in older patients with type 2 diabetes.
Afr J Prim Health Care Fam Med
December 2024
Department of Anaesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver.
In older adults with type 2 diabetes (T2DM), tight glycaemic control (HbA1c 7%) can result in more harm than benefit, especially when using insulin or sulfonylureas. Older adults are at higher risk for adverse drug events, especially hypoglycaemia, which may cause falls, confusion and hospitalisations. This Therapeutic Letter evaluates the risks of tight glycaemic control in older adults with T2DM, focusing on deprescribing diabetes medications in those over 65, especially those with multimorbidity and polypharmacy.
View Article and Find Full Text PDFA patient-centred care model for patients with complicated multimorbidity: Protocol for a pilot cluster randomised trial in general practice, municipalities, and hospitals.
PLoS One
December 2024
Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Region Zealand, Slagelse, Denmark.
Introduction: Current care is inadequate for patients with complicated multimorbidity, and frequently results in fragmented care. There is no widely agreed-upon optimal organisation of healthcare services for this patient group. By drawing upon existing literature and prior studies, we developed a patient-centred complex intervention for multimorbidity (CIM) and subsequently refined it into CIM version 2 (CIM2).
View Article and Find Full Text PDFManaging diabetic chronic kidney disease in pregnancy: Current clinical practice and uncertainties.
Diabet Med
February 2025
Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Background: Pre-gestational diabetes occurs in approximately 1% of pregnancies in the UK and increases the risk of adverse maternal and fetal outcomes. More women with type 2 than type 1 diabetes are now becoming pregnant and tend to have higher rates of obesity and other multi-morbidities. Chronic kidney disease (CKD) affects approximately 5%-10% of pregnant women with type 1 diabetes and about 2%-3% with type 2 diabetes.
View Article and Find Full Text PDFRelationally competent attitudes and actions: a systematic review of general practice literature.
Scand J Prim Health Care
October 2024
Centre for General Practice: The Section of General Practice Medicine and The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Objective: To explore core elements from Teachers' Relational Competence in general practice literature regarding building relationships in consultations, specifying actions doctors take to create and maintain relationship quality with patients. This systematic literature review aims to map and propose a similar framework for the doctor-patient relationship.
Background: The doctor-patient relationship, a well-researched yet complex field, often lacks clear descriptions.
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