dc.contributor.author	Sinnott, Carol
dc.contributor.author	McHugh, Sheena M.
dc.contributor.author	Browne, John P.
dc.contributor.author	Bradley, Colin P.
dc.contributor.funder	Health Research Board	en
dc.date.accessioned	2017-04-05T16:02:22Z
dc.date.available	2017-04-05T16:02:22Z
dc.date.issued	2013-09
dc.date.updated	2017-04-05T15:17:30Z
dc.description.abstract	Objective To synthesise the existing published literature on the perceptions of general practitioners (GPs) or their equivalent on the clinical management of multimorbidity and determine targets for future research that aims to improve clinical care in multimorbidity. Design Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore GPs’ experiences of clinical management of multimorbidity or multiple chronic diseases. Data sources EMBASE, MEDLINE, CINAHL, PsycInfo, Academic Search Complete, SocIndex, Social Science Full Text and digital theses/online libraries (database inception to September 2012) to identify literature using qualitative methods (focus groups or interviews). Review methods The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. Results Of 1805 articles identified, 37 were reviewed in detail and 10 were included, using a total of 275 GPs in 7 different countries. Four areas of difficulty specific to the management of multimorbidity emerged from these papers: disorganisation and fragmentation of healthcare; the inadequacy of guidelines and evidence-based medicine; challenges in delivering patient-centred care; and barriers to shared decision-making. A ‘line of argument’ was drawn which described GPs’ sense of isolation in decision-making for multimorbid patients. Conclusions This systematic review shows that the problem areas for GPs in the management of multimorbidity may be classified into four domains. There will be no ‘one size fits all’ intervention for multimorbidity but these domains may be useful targets to guide the development of interventions that will assist and improve the provision of care to multimorbid patients.	en
dc.description.sponsorship	Health Research Board (HRBNSAFP/2011/3 (CS) and HRBICE/2012/12 (SMH))	en
dc.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.articleid	e003610
dc.identifier.citation	Sinnott, C., Mc Hugh, S., Browne, J. and Bradley, C. (2013) 'GPs’ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research', BMJ Open, 3:e003610. doi:10.1136/bmjopen-2013-00361	en
dc.identifier.issn	2044-6055
dc.identifier.journaltitle	BMJ Open	en
dc.identifier.uri	https://hdl.handle.net/10468/3857
dc.identifier.volume	3	en
dc.language.iso	en	en
dc.publisher	BMJ Publishing Group	en
dc.relation.uri	http://bmjopen.bmj.com/content/bmjopen/3/9/e003610.full.pdf
dc.rights	This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/	en
dc.rights.uri	https://creativecommons.org/licenses/by-nc/3.0/	en
dc.subject	Multimorbidity	en
dc.subject	General practitioners	en
dc.title	GPs’ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research	en
dc.type	Article (peer-reviewed)	en

GPs’ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research

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