Ageing well: improving the management of patients with multiple chronic health problems.
OBJECTIVE
To identify and evaluate the management and care of older people with multiple chronic health problems (MCHP).


METHODS
Administrative health data from the Department of Veterans' Affairs and bio-social data from the Australian Longitudinal Study of Ageing are used to determine prevalence of MCHP, treatment patterns and patient outcomes. Focus groups and semistructured interviews are used to gain patient and health practitioner perspectives.


RESULTS
The prevalence of MCHP in older people is high (65%) and is associated with increased use of health services, mortality and poorer self-rated health. Australian disease-specific guidelines fail to address MCHP, and treatment conflicts with the potential to cause harm, were common.


CONCLUSIONS
Improvements in the care and management of older people with MCHP requires: a multifaceted approach, across the health-care system; better coordination of holistic, patient-centred multidisciplinary care; and effective communication and education of all stakeholders. The Health reform agenda in Australia provides an opportunity for change.
Quality Use of Medicines and Pharmacy Research Centre (QUMPRC), Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia. andrew.gilbert@unisa.edu.au
Andrew L
AL
Gilbert
Gillian E
GE
Caughey
Agnes I
AI
Vitry
Alice
A
Clark
Philip
P
Ryan
Robyn A
RA
McDermott
Sepehr
S
Shakib
Mary A
MA
Luszcz
Adrian
A
Esterman
Elizabeth E
EE
Roughead
D000368:Aged; D000375:Aging; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D015995:Prevalence