Scaling Up Patient-Centered Interdisciplinary Care for Multimorbidity: A Pragmatic Mixed-Methods Randomized Controlled Trial

Article Figures & Data

Table 1

Control and Intervention Group Characteristics at Baseline^{^a} (N = 248)

Characteristic	Control (n = 140)	Intervention (n = 144)
Age, mean (SD), y	61.1 (10.3)	60.8 (10.6)
Number of chronic diseases, mean (SD)	5.0 (1.7)	5.0 (1.9)
Males, No. (%)	63 (45.0)	69 (47.9)
Education level, No. (%)
Incomplete secondary school	30 (21.4)	36 (25.0)
Completed secondary school	38 (27.1)	30 (20.8)
College	54 (38.6)	66 (45.8)
University	18 (12.9)	12 (8.3)
Household income in CAD$, No. (%)
<20,000	26 (18.6)	26 (18.1)
20,000-49,999	54 (38.6)	52 (36.1)
≥50,000	55 (39.3)	59 (41.0)
Missing data	5 (3.6)	7 (4.9)
Marital status, No. (%)
Married	92 (65.7)	92 (63.9)
Single or divorced	43 (30.7)	43 (29.9)
Widower	5 (3.6)	9 (6.3)
Employment, No. (%)
Employed	45 (32.1)	51 (35.4)
Unemployed	26 (18.6)	26 (18.1)
Retired	69 (49.3)	67 (46.5)

CAD$ = Canadian dollars
↵^aDifferences between both groups were not statistically different for any characteristic.

Table 2

Results of Primary Outcomes

Primary Outcome		T1		T2	Marginal Mean Differences
Primary Outcome	No.	Mean (SD)	No.	Mean (SD)	Mean at T2	Difference I-C^{^a} (95% CI)	P Value^{^b}
Healthdirected behavior
Control	140	2.82 (0.90)	118	2.80 (0.91)	2.84
Intervention	144	2.82 (0.92)	127	2.91 (0.88)	2.89	0.05 (-0.12 to 0.22)	.55
Positive, active engagement in life
Control	140	3.62 (0.41)	118	3.65 (0.40)	3.66
Intervention	144	3.58 (0.43)	127	3.62 (0.42)	3.62	-0.04 (-0.13 to 0.05)	.42
Emotional well-being
Control	140	3.09 (0.78)	118	3.25 (0.76)	3.27
Intervention	144	3.09 (0.75)	127	3.26 (0.74)	3.25	-0.02 (-0.16 to 0.13)	.81
Self-monitoring and insight
Control	140	3.51 (0.37)	118	3.39 (0.42)	3.39
Intervention	144	3.54 (0.36)	127	3.63 (0.37)	3.62	0.23 (0.13 to 0.32)	<.01
Constructive attitudes, approaches
Control	140	3.63 (0.45)	118	3.70 (0.40)	3.69
Intervention	144	3.58 (0.51)	127	3.65 (0.51)	3.66	-0.03 (-0.12 to 0.07)	.57
Skill and technique acquisition
Control	140	3.44 (0.53)	118	3.52 (0.51)	3.53
Intervention	144	3.45 (0.51)	127	3.61 (0.50)	3.61	0.08 (-0.03 to 0.17)	.17
Social integration and support
Control	139	3.51 (0.55)	118	3.59 (0.51)	3.55
Intervention	144	3.37 (0.71)	127	3.54 (0.67)	3.58	0.02 (-0.08 to 0.13)	.64
Health service navigation
Control	140	3.77 (0.38)	118	3.78 (0.43)	3.77
Intervention	144	3.74 (0.38)	127	3.82 (0.29)	3.82	0.06 (-0.02 to 0.13)	.16
Self-efficacy score
Control	140	7.6 (1.50)	118	7.8 (1.50)	7.76
Intervention	142	7.6 (1.8)	127	7.8 (1.6)	7.84	0.08 (-0.21 to 0.37)	.58

I-C = intervention minus control; T1 = baseline; T2 = study end point at 4 months.
↵^aDifference I-C = marginal mean at T2 (intervention) - marginal mean at T2 (control).
↵^bMultilevel modeling (linear mixed model) comparing results at T2, adjusted for scores at T1 and the practice.

Table 3

Results of Secondary Outcomes (Continuous Variables)

		T1		T2		Marginal Mean Differences
Secondary Outcome	No.	Mean (SD)	No.	Mean (SD)	Mean at T2	Difference I-C^{^a} (95% CI)	P Value ^{^b}
VR-12 Physical Component Summary
Control	140	39.5 (10.5)	118	40.9 (9.3)	41.25	-0.35 (-2.31 to 1.62)	.73
Intervention	144	40.5 (11.0)	127	41.1 (10.7)	40.91
VR-12 Mental Component Summary
Control	140	54.7 (9.5)	118	54.8 (9.6)	54.67	0.68 (-1.42 to 2.78)	.52
Intervention	144	53.6 (11.5)	127	55.4 (10.4)	55.35
EQ-5D-5L Index
Control	139	0.839 (0.126)	118	0.850 (0.112)	0.850	-0.020 (-0.047 to 0.007)	.14
Intervention	144	0.838 (0.145)	127	0.831 (0.152)	0.830

EQ-5D-5L = 5-level EuroQol 5-dimensions questionnaire; I-C = intervention minus control; T1 = baseline; T2 = study end point at 4 months; VR-12 = Veterans RAND 12-Item Health Survey.
↵^aDifference I-C = marginal mean at T2 (intervention) - marginal mean at T2 (control).
↵^bMultilevel modeling (linear mixed model) comparing results at T2, adjusted for scores at T1 and the practice.

Table 4

Results of Secondary Outcomes (Dichotomous Variables)

Secondary Outcome	T1^{^a}	T2^{^b}	OR (95% CI)	P Value ^{^c}
Psychological distress (K6)
Control	64 (45.7)	42 (35.9)
Intervention	64 (44.4)	44 (34.6)	1.08 (0.57-2.03)	.824
High-risk alcohol consumption
Control	12 (8.6)	10 (8.5)
Intervention	7 (4.9)	7/127 (5.5)	1.24 (0.24-6.54)	.798
Smoking habit
Control	21 (15.0)	22 (18.6)
Intervention	32 (22.2)	29 (22.8)	2.40 (0.46-12.37)	.297
Physical activity
Control	72 (51.4)	55 (46.6)
Intervention	63 (43.8)	76 (59.8)	2.60 (1.37-4.93)	.003
Healthy eating
Control	75 (53.6)	70 (59.3)
Intervention	70 (48.6)	92 (72.4)	2.42 (1.30-4.50)	.006

K6 = Kessler 6-item Psychological Distress Scale Questionnaire; OR = odds ratio; T1 = baseline; T2 = study end point at 4 months.
↵^aTotal size per group at T1: control n = 140, intervention n = 144.
↵^bTotal size per group at T2: control n = 118 (except n = 117 for psychological distress), intervention n = 127.
↵^bMultilevel modeling (generalized linear mixed model) comparing results at T2, adjusted for values at T1 and the practice.