title: Primary care physicians' prevention counseling with patients with multiple morbidity.
abstract: The prevalence of multiple health conditions, or multiple morbidity (MM), is increasing. Providing medical care for adults with MM presents challenges, including balancing disease management with prevention. We conducted in-depth semistructured interviews with 12 primary care physicians to explore their perspectives on prevention counseling among patients with MM. Participants described the complex relationship between disease management and prevention, highlighted the importance of patient motivation, and discussed various strategies to promote receptivity to prevention recommendations. The perceived potential benefits of prevention recommendations encouraged physicians to persist with such counseling, despite challenges presented by visit time constraints, reimbursement procedures, and concerns over futility. Physicians recommended the development of alternate care delivery and reimbursement models to overcome challenges of the existing health care system and to meet the prevention needs of patients with MM. We explore the implications of these findings for maximizing the health and quality of life of adults with MM.
authors.affiliation: University of Kentucky, Lexington, Kentucky40536-0284, USA. shbardach@uky.edu
authors.forename: Shoshana H
authors.initials: SH
authors.lastname: Bardach
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015897:Comorbidity; D003376:Counseling; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009042:Motivation; D010819:Physician's Role; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D011322:Primary Prevention; D011788:Quality of Life