title: "Where do we go from here?" Health system frustrations expressed by patients with multimorbidity, their caregivers and family physicians.
abstract: OBJECTIVE
  This study explored the care challenges experienced by older patients with multimorbidity, their informal caregivers and family physicians.
  
  
  METHODS
  Semi-structured interviews were conducted with 27 patients, their informal caregivers and family physicians. Qualitative description was used to identify key themes in the interview transcripts.
  
  
  RESULTS
  Participants experienced many common challenges when managing multimorbidity, including a lack of decision-making support, poor communication and uncoordinated health services. Within these themes, unique perspectives specific to the role of being a patient, caregiver or family physician emerged.
  
  
  CONCLUSIONS
  The study adds to a limited evidence base on the experience of patients with multimorbidity. By including the perspectives of their family caregivers and physicians, we provide important insight into the management of multimorbidity and recommend the uptake of specific strategies to address them.
authors: Graduate Student, Institute of Health Policy, Management & Evaluation, University of Toronto, Bridgepoint Collaboratory for Research and Innovation, Bridgepoint Active Healthcare, Toronto, ON.
authors: Ashlinder
authors: A
authors: Gill
authors: Research Scientist, Bridgepoint Collaboratory for Research and Innovation, Bridgepoint Active Healthcare, Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON.
authors: Kerry
authors: K
authors: Kuluski
authors: Department of Family and Community Medicine, Primary Care Research Unit, Sunnybrook Health Sciences Centre, Scientist, Institute for Clinical Evaluative Sciences, Toronto, ON.
authors: Liisa
authors: L
authors: Jaakkimainen
authors: Graduate Student, Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON.
authors: Gayathri
authors: G
authors: Naganathan
authors: Bridgepoint Collaboratory for Research and Innovation, Bridgepoint Active Healthcare, Department of Family and Community Medicine, Primary Care Research Unit, Sunnybrook Health Sciences Centre, Adjunct Scientist, Institute for Clinical Evaluative Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON.
authors: Ross
authors: R
authors: Upshur
authors: Institute of Health Policy, Management & Evaluation, University of Toronto Adjunct Scientist, Institute for Clinical Evaluative Sciences Research Scientist, Toronto Rehabilitation Institute, Toronto, ON.
authors: Walter P
authors: WP
authors: Wodchis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D002908:Chronic Disease / Q000628:therapy; D003142:Communication; D015897:Comorbidity; D003266:Continuity of Patient Care; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010349:Patient Compliance; D010821:Physicians, Family; D011787:Quality of Health Care; D014850:Waiting Lists