DEGAM-Leitlinie „Multimorbidität" im Praxistest

Background: Medical guidelines address specific diseases or symptoms but hardly consider the specific situation of multimorbidity in patients. The aim of the current field test was to evaluate the acceptance and practicability of the German College of General Practitioners and Family Physicians' draft guideline "multimorbidity" for family practitioners (FPs) and patients and to collect aspects for its implementation. Methods: In the federal state of Schleswig-Holstein, Germany, 450 FPs were asked to participate in this field test. Each FP was asked to recruit at least one multimorbid patient for participation in the field test. The guideline consisted of a long version, a short version and a patient information called "people with several diseases". The guideline was supposed to be tested for a four-week period. The patients received the patient information. The acceptance and practicability of the guideline was evaluated with focus group discussions or interviews, transcribed verbatim and analysed using content analysis. Results: Of the 18 FPs who expressed their interest in taking part, nine participated and of the eleven patients who were interested, ten participated in the field test. There was consensus regarding the necessity of a "multimorbidity" guideline. FPs and patients perceived the patient information as well-documented. However, the participants perceived, within the guideline, the lack of a more detailed investigation of specific reasons for consultations such as mental symptoms and experienced medical history. Furthermore, FPs claimed they were in need of a prioritization tool for treating the leading disease, to facilitate everyday practice. Conclusions: There is a need for the guideline "multimorbidity" including patient information. However, concrete instructions and a closer investigation of specific reasons for encounter are still missing. Moreover, the importance of the guideline is seen above all in the educational support it provides for patients and students.