title: GPs' and pharmacists' experiences of managing multimorbidity: a 'Pandora's box'.
abstract: BACKGROUND
  Multimorbidity is defined as the occurrence of two or more chronic diseases in one individual. Patients with multimorbidity generally have poorer health and functioning and higher rates of attendance in primary care and specialty settings.
  
  
  OBJECTIVE
  To explore the views and attitudes of GPs and pharmacists managing patients with multimorbidity in primary care.
  
  
  METHODS
  Qualitative study using focus groups.
  
  
  METHODS
  Primary care in Ireland.
  
  
  METHODS
  Three focus groups were held in total, involving 13 GPs and seven pharmacists. Focus groups were recorded, transcribed, and analysed using the 'framework' approach.
  
  
  RESULTS
  The predominant themes to emerge from the focus groups were: 1) the concept of multimorbidity and the link to polypharmacy and ageing; 2) health systems issues relating to lack to time, inter-professional communication difficulties, and fragmentation of care; 3) individual issues from clinicians relating to professional roles, clinical uncertainty, and avoidance; 4) patient issues; and 5) potential management solutions.
  
  
  CONCLUSIONS
  This study provides information on the significant impact of multimorbidity from a professional perspective. It highlights potential elements of an intervention that could be designed and tested to achieve improvements in the management of multimorbidity, outcomes for individuals affected, and the experiences of those providing healthcare.
authors.affiliation: Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, AMNCH, Tallaght Hospital, Dublin 24, Ireland. susmith@tcd.ie
authors.forename: Susan M
authors.initials: SM
authors.lastname: Smith
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'Kelly
authors.forename: Tom
authors.initials: T
authors.lastname: O'Dowd
mesh_terms: D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000628:therapy*; D005194:Family Practice / Q000379:methods*; D006801:Humans; D007400:Interprofessional Relations; D007494:Ireland; D010595:Pharmacists / Q000523:psychology*; D010821:Physicians, Family / Q000523:psychology*; D011364:Professional Practice