Patient-centeredness of integrated care programs for people with multimorbidity. Results from the European ICARE4EU project

Abstract

Introduction: This paper aims to support the implementation of patient-centered care for people withmultimorbidity in Europe, by providing insight into ways in which patient-centeredness is currentlyshaped in integrated care programs for people with multimorbidity in European countries.Methods: In 2014, expert organizations in 31 European countries identified 200 integrated care practices(‘programs’) in 25 countries of which 123 were included in our study. Managers of 112 programs from24 countries completed a questionnaire about characteristics and results of the program, including ques-tions on elements of patient-centeredness. Eight programs that were considered especially innovativeor promising were analyzed in depth.Results: Programs used various methodologies to involve people with multimorbidity in decision-making,such as motivational interviewing and narrative counseling techniques. In 79 programs individual careplans were developed together with patients. Few programs had already been systematically evaluated,but in one program it was shown that working with individual care plans based on patients’ goals andresources resulted in increased patient satisfaction with care. Various barriers to deliver patient-centeredcare were reported, including inadequate knowledge and skills of both patients and professionals.Conclusion: In many European countries innovative approaches are applied to increase patient-centeredness of care for people with multimorbidity. To assess their potential benefits and conditions forimplementation, thorough process and outcome evaluations of programs are urgently needed.