Background

Research has shown that people aged 65+ who have multiple long-term conditions – multimorbidity (MLTC-M) can experience problems when communicating with healthcare staff. These problems can lead to patients feeling uncertain about issues relating to their health and healthcare, and to staff not understanding patients’ needs and concerns. Sometimes, this can compromise patient safety.

In-depth interview study

We wanted to develop a better understanding of how people aged 65+ who have multiple long-term conditions communicate with healthcare staff, the problems they face in doing so, and how these can be overcome. We interviewed:

• 28 people aged 65+ who have multiple (that is, two or more) long-term conditions
• 18 staff (clinical and administrative) working in UK General Practices

Initial results from this study have been shared at three UK and one international conference. Full results are being written up for publication.

Design workshops

We used our understanding from the in-depth interview study to design materials to help improve communication. Through a series of five workshops, we collaborated with patients, carers, staff and other experts to decide what these materials should contain.

We created a booklet for patients called “How to get the most out of your General Practice”, and a guide to this booklet for General Practice staff. The booklet contains information and guidance to help people aged 65+ who have multiple long-term conditions talk to and be heard by staff.

Outcomes from this study have been shared at one UK (HSR UK) and one international (ICCH) conference (see results).

Cognitive interview study

We wanted to know if the booklet we had created made sense and if people would be happy to use it. We showed the booklet to 15 people aged 65+ who had multiple long-term conditions, and asked them to think-aloud as they read through it. Based on the feedback we received, we made changes to the design, layout, content and wording of the booklet.

The process of developing the booklet is being written up for publication.

Feasibility study and process evaluation

Finally, we wanted to know if we could recruit General Practices and patients to take part in a study of these guidance materials and, if so, whether people would use these materials and find them useful. We recruited five General Practices and 42 people aged 65+ who had multiple long-term conditions. We asked these people and staff from the General Practices to read and make use of the guidance materials. All were asked to complete questionnaires and some were invited to take part in an interview (process evaluation) about their views of the materials and their experience of taking part in the study.

This work is being written up for publication.