The CARE Plus study – a whole-system intervention to improve quality of life of primary care patients with multimorbidity in areas of high socioeconomic deprivation: exploratory cluster randomised controlled trial and cost-utility analysis

Stewart Mercer , Bridie Fitzpatrick , Bruce Guthrie , Elisabeth Fenwick, Eleanor Grieve , Kenny Lawson , Nicki Boyer , Alex McConnachie, Suzanne Lloyd , Rosaleen O'Brien, Graham Watt , Sally Wyke

Research output: Contribution to journalArticle

121 Downloads (Pure)

Abstract

Multimorbidity is common in deprived communities and reduces quality of life. Our aim was to evaluate a whole-system primary care-based complex intervention, called CARE Plus, to improve quality of life in multimorbid patients living in areas of very high deprivation. We used a phase 2 exploratory cluster randomised controlled trial with eight general practices in Glasgow in very deprived areas that involved multimorbid patients aged 30–65 years. The intervention comprised structured longer consultations, relationship continuity, practitioner support, and self-management support. Control practices continued treatment as usual. Primary outcomes were quality of life (EQ-5D-5L utility scores) and well-being (W-BQ12; 3 domains). Cost-effectiveness from a health service perspective, engagement, and retention were assessed. Recruitment and baseline measurements occurred prior to randomisation. Blinding post-randomisation was not possible but outcome measurement and analysis were masked. Analyses were by intention to treat.
Original languageEnglish
JournalBMC Medicine
Volume14
Issue number88
Early online date22 Jun 2016
DOIs
Publication statusPublished - Jun 2016

Fingerprint

Cost-Benefit Analysis
Comorbidity
Primary Health Care
Randomized Controlled Trials
Quality of Life
Random Allocation
Intention to Treat Analysis
Self Care
General Practice
Health Services
Referral and Consultation
Therapeutics

Keywords

  • multimorbidity
  • complex intervention
  • General Practice
  • care plan
  • primary care
  • deprivation
  • socioeconomic status
  • consultation time
  • mindfulness
  • empathy

Cite this

Mercer , Stewart ; Fitzpatrick , Bridie ; Guthrie , Bruce ; Fenwick, Elisabeth ; Grieve , Eleanor ; Lawson , Kenny ; Boyer , Nicki ; McConnachie, Alex ; Lloyd , Suzanne ; O'Brien, Rosaleen ; Watt , Graham ; Wyke, Sally. / The CARE Plus study – a whole-system intervention to improve quality of life of primary care patients with multimorbidity in areas of high socioeconomic deprivation: exploratory cluster randomised controlled trial and cost-utility analysis. In: BMC Medicine. 2016 ; Vol. 14, No. 88.
@article{4785aedf10d64f48a2f5e9a0bbc3c3c0,
title = "The CARE Plus study – a whole-system intervention to improve quality of life of primary care patients with multimorbidity in areas of high socioeconomic deprivation: exploratory cluster randomised controlled trial and cost-utility analysis",
abstract = "Multimorbidity is common in deprived communities and reduces quality of life. Our aim was to evaluate a whole-system primary care-based complex intervention, called CARE Plus, to improve quality of life in multimorbid patients living in areas of very high deprivation. We used a phase 2 exploratory cluster randomised controlled trial with eight general practices in Glasgow in very deprived areas that involved multimorbid patients aged 30–65 years. The intervention comprised structured longer consultations, relationship continuity, practitioner support, and self-management support. Control practices continued treatment as usual. Primary outcomes were quality of life (EQ-5D-5L utility scores) and well-being (W-BQ12; 3 domains). Cost-effectiveness from a health service perspective, engagement, and retention were assessed. Recruitment and baseline measurements occurred prior to randomisation. Blinding post-randomisation was not possible but outcome measurement and analysis were masked. Analyses were by intention to treat.",
keywords = "multimorbidity , complex intervention, General Practice , care plan, primary care, deprivation, socioeconomic status, consultation time, mindfulness, empathy",
author = "Stewart Mercer and Bridie Fitzpatrick and Bruce Guthrie and Elisabeth Fenwick and Eleanor Grieve and Kenny Lawson and Nicki Boyer and Alex McConnachie and Suzanne Lloyd and Rosaleen O'Brien and Graham Watt and Sally Wyke",
note = "Acceptance date: 2-6-16 Online pub date: 22-6-16 Publisher version uploaded 22-6-16 Gold OA (BioMedCentral)",
year = "2016",
month = "6",
doi = "10.1186/s12916-016-0634-2",
language = "English",
volume = "14",
journal = "BMC Medicine",
issn = "1741-7015",
publisher = "BioMed Central Ltd.",
number = "88",

}

The CARE Plus study – a whole-system intervention to improve quality of life of primary care patients with multimorbidity in areas of high socioeconomic deprivation: exploratory cluster randomised controlled trial and cost-utility analysis. / Mercer , Stewart ; Fitzpatrick , Bridie ; Guthrie , Bruce ; Fenwick, Elisabeth; Grieve , Eleanor; Lawson , Kenny ; Boyer , Nicki ; McConnachie, Alex; Lloyd , Suzanne ; O'Brien, Rosaleen; Watt , Graham ; Wyke, Sally.

In: BMC Medicine, Vol. 14, No. 88, 06.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The CARE Plus study – a whole-system intervention to improve quality of life of primary care patients with multimorbidity in areas of high socioeconomic deprivation: exploratory cluster randomised controlled trial and cost-utility analysis

AU - Mercer , Stewart

AU - Fitzpatrick , Bridie

AU - Guthrie , Bruce

AU - Fenwick, Elisabeth

AU - Grieve , Eleanor

AU - Lawson , Kenny

AU - Boyer , Nicki

AU - McConnachie, Alex

AU - Lloyd , Suzanne

AU - O'Brien, Rosaleen

AU - Watt , Graham

AU - Wyke, Sally

N1 - Acceptance date: 2-6-16 Online pub date: 22-6-16 Publisher version uploaded 22-6-16 Gold OA (BioMedCentral)

PY - 2016/6

Y1 - 2016/6

N2 - Multimorbidity is common in deprived communities and reduces quality of life. Our aim was to evaluate a whole-system primary care-based complex intervention, called CARE Plus, to improve quality of life in multimorbid patients living in areas of very high deprivation. We used a phase 2 exploratory cluster randomised controlled trial with eight general practices in Glasgow in very deprived areas that involved multimorbid patients aged 30–65 years. The intervention comprised structured longer consultations, relationship continuity, practitioner support, and self-management support. Control practices continued treatment as usual. Primary outcomes were quality of life (EQ-5D-5L utility scores) and well-being (W-BQ12; 3 domains). Cost-effectiveness from a health service perspective, engagement, and retention were assessed. Recruitment and baseline measurements occurred prior to randomisation. Blinding post-randomisation was not possible but outcome measurement and analysis were masked. Analyses were by intention to treat.

AB - Multimorbidity is common in deprived communities and reduces quality of life. Our aim was to evaluate a whole-system primary care-based complex intervention, called CARE Plus, to improve quality of life in multimorbid patients living in areas of very high deprivation. We used a phase 2 exploratory cluster randomised controlled trial with eight general practices in Glasgow in very deprived areas that involved multimorbid patients aged 30–65 years. The intervention comprised structured longer consultations, relationship continuity, practitioner support, and self-management support. Control practices continued treatment as usual. Primary outcomes were quality of life (EQ-5D-5L utility scores) and well-being (W-BQ12; 3 domains). Cost-effectiveness from a health service perspective, engagement, and retention were assessed. Recruitment and baseline measurements occurred prior to randomisation. Blinding post-randomisation was not possible but outcome measurement and analysis were masked. Analyses were by intention to treat.

KW - multimorbidity

KW - complex intervention

KW - General Practice

KW - care plan

KW - primary care

KW - deprivation

KW - socioeconomic status

KW - consultation time

KW - mindfulness

KW - empathy

U2 - 10.1186/s12916-016-0634-2

DO - 10.1186/s12916-016-0634-2

M3 - Article

VL - 14

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

IS - 88

ER -