Abstract
One of the consequences of an ageing population is the increasing prevalence of people living with more than one long-term condition (multi-morbidity). The coexistence of more than one long-term condition often has poorer outcomes for older adults and makes them more likely to access care from different health and social care providers concurrently. As a result, the overall cost of managing these individuals increases. Collaborative care is a useful way of providing care for such patients, utilising the skills and expertise of different disciplines in primary, secondary care and other settings in a coordinated way. Stepped care ensures that interventions match the severity and complexity of presentation so that effort is not wasted.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3(3):223–8.
Smith SM, Wallace E, O’Dowd T, Fortin M. Interventions for improving outcomes in patients with multimorbidity in primary care and community settings. Cochrane Database of Syst Rev. 2016;3:CD006560. https://doi.org/10.1002/14651858.CD006560.pub3.
Valderas JM, Mercer S, Fortin M. Research on patients with multiple health conditions: different constructs, different views, one voice. J Comorb. 2011;1(1):1–3.
Rushton CA, Satchithananda DK, Kadam UT. Comorbidity in modern nursing: a closer look at heart failure. Br J Nurs. 2011;20(5):280–5.
Hindmarsh D, Loh M, Finch CF, Hayen A, Close JC. Effect of comorbidity on relative survival following hospitalisation for fall-related hip fracture in older people. Australas J Ageing. 2014;33(3):E1.
Payne RA, Abel GA, Guthrie B, Mercer SW. The effect of physical multimorbidity, mental health conditions and socioeconomic deprivation on unplanned admissions to hospital: a retrospective cohort study. Can Med Assoc J. 2013;185(5):E221–8.
Brettschneider C, Leicht H, Bickel H, Dahlhaus A, Fuchs A, MultiCare Study Group. Relative impact of multimorbid chronic conditions on health-related quality of life – results from the MultiCare Study Group. PLoS One. 2013;8(6):e66742.
Martín-García S, Rodríguez-Blázquez C, Martínez-López I, Martínez-Martín P, Forjaz MJ. Comorbidity health status, and quality of life in institutionalized older people with and without dementia. Int Psychogeriatr. 2013;25(7):1077–84.
Verbrugge LM, Lepkowski JM, Imanaka Y. Comorbidity and its impact on disability. Milbank Q. 1989;67(3–4):450–84.
McClure RJ, Turner C, Peel N, Spinks A, Eakin E, Hughes K. Population-based interventions for the prevention of fall-related injuries in older people. Cochrane Database of Syst Rev. 2005;1:CD004441. https://doi.org/10.1002/14651858.CD004441.pub2.
Vu T, Finch CF, Day L. Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: a cluster analysis. BMC Geriatr. 2011;11:45.
Duerden M, Avery T, Payne R. Polypharmacy and medicines optimisation. https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/polypharmacy-and-medicines-optimisation-kingsfund-nov13.pdf. Accessed Dec 2016.
Ivbijaro GO, Enum Y, Khan AA, Lam SS-K, Gabzdyl A. Collaborative care: models for treatment of patients with complex medical-psychiatric conditions. Curr Psychiatry Rep. 2014;16:506.
Ivbijaro G. Mental health: a resilience factor against both NCDs and CDs. In: Commonwealth health partnerships 2012. Cambridge: Nexus Strategic Partnerships; 2012. p. 17–20.
World Health Organization. The global burden of disease: 2004 update. Geneva: The World Health Organization; 2008.
Wallace E, Salisbury C, Guthrie B, Lewis C, Fahey T, Smith SM. Managing patients with multimorbidity in primary care. BMJ. 2015;350:176.
Katon W, Russo J, Lin EHB, Schmittdiel J, Ciechanowski P, Ludman E, et al. Cost-effectiveness of a multicondition collaborative care intervention. Arch Gen Psychiatry. 2012;69(5):506–14.
Huang Y, Wei X, Wu T, Chen R, Guo A. Collaborative care for patients with depression and diabetes mellitus: a systematic review and meta-analysis. BMC Psychiatry. 2013;13:260–71.
Unützer J, Harbin H, Schoenbaum M, Druss B. The collaborative care model: an approach for integrating physical and mental health car in Medicaid Health Homes. Center for Health Strategies and Mathematica Policy Research; 2013.
Watson LC, Amick HR, Gaynes BN, Brownley KA, Thaker S, Viswanaathan M, et al. Practice-based interventions addressing concomitant depression and chronic medical conditions in the primary care setting: a systematic review and meta-analysis. J Prim Care Community Health. 2013;4(4):294–306.
National Institute for Health and Care Excellence. Common mental health problems: identification and pathways to care. NICE clinical guideline 123. NICE 2011. https://www.nice.org.uk/guidance/cg123.
Oosterbaan DB, Verbraak MJPM, Terluin B, et al. Collaborative stepped care v. care as usual for common mental disorders: 8-month, cluster randomised controlled trial. Br J Psychiatry. 2013;203:132–9.
Franx G, Oud M, de Lange J, et al. Implementing a stepped-care approach in primary care: results of a qualitative study. Implement Sci. 2012;7:8.
National Institute for Health and Care Excellence. Depression in adults: recognition and management (Updated 2016) NICE clinical guideline 90. NICE 2009. https://www.nice.org.uk/guidance/cg90.
Richards DA. Stepped care: a method to deliver increased access to psychological therapies. Can J Psychiatr. 2012;57(4):210–5.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Ivbijaro, G., Goldberg, D., Enum, Y., Kolkiewicz, L. (2019). Comorbidity, Multi-Morbidity, Stepped Care and Skill Mix in the Care of the Older Population. In: de Mendonça Lima, C., Ivbijaro, G. (eds) Primary Care Mental Health in Older People. Springer, Cham. https://doi.org/10.1007/978-3-030-10814-4_5
Download citation
DOI: https://doi.org/10.1007/978-3-030-10814-4_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-10812-0
Online ISBN: 978-3-030-10814-4
eBook Packages: MedicineMedicine (R0)