The Article in Brief

Barriers to Self-Management and Quality of Life Outcomes in Seniors With Multimorbidities

Elizabeth A. Bayliss, MD, MSPH , and colleagues

Background In this study, seniors with chronic diseases were surveyed about barriers that prevent them from caring for themselves and that contribute to a sense of worse health.

What This Study Found Three-hundred fifty-two seniors completed the survey questionnaire and had an average of 8.7 chronic diseases. The following barriers to self-care, which were identified by the participants, are related to worse health: more chronic health conditions, lower level of physical functioning, less knowledge about medical conditions, less social activity, ongoing depression, financial difficulties, and male sex. These barriers could be addressed by identifying and treating depression, educating patients about their medical conditions; increased physical therapy and other support, ensuring that symptoms and treatments for separate conditions do not interfere with each other, and coordinating patient care while taking into account patients’ financial resources.

Implications

• Medical care that emphasizes management of individual diseases may not meet the needs of patients with multiple chronic conditions.
• Psychosocial factors should be taken into account when caring for patients with multiple chronic conditions.
• Clinicians need to identify the individual needs of patients with chronic illnesses, help match those needs with resources, and periodically reassess to determine whether their needs have changed.