An academic primary care research agenda for multimorbidity: a Delphi consensus study

Conference:

SAPC ASM 2023 - Brighton

Talk Code:

5C.6

Presenter:

Jonathan Stokes

Twitter:

@DukeStokes

Co-authors:

Peter Bower, Susan M Smith, Bruce Guthrie, Thomas Blakeman, Jose M Valderas, Chris Salisbury

Author institutions:

University of Glasgow, The University of Manchester, Trinity College Dublin, University of Edinburgh, National University of Singapore, University of Bristol

Problem

Multimorbidity has been identified as a priority research topic, globally. Research priorities from a patient’s perspective, and research funders’, have been set. However, the perspective from primary care has not yet been formalised. The academic primary care perspective is likely to be vital for informing this topic. Most patients with multimorbidity receive the majority of their care in the primary care setting, and this research is of direct relevance to GPs and the wider workforce. We aimed to identify and prioritise an academic primary care research agenda for multimorbidity.

Approach

Three-phase priority setting study with primary care multimorbidity researchers from the UK and other high-income countries. (i) Initial open-ended survey question to generate a long list of questions, (ii) face-to-face workshop to distil/expand these questions, each with researchers from NIHR School for Primary Care Research (SPCR) centres; (iii) final Delphi consensus survey with 27 international multimorbidity researchers over two rounds.

Findings

25 primary care researchers from eight of the nine SPCR centres responded to the initial survey, generating 85 unanswered questions. 18 participants attended the workshop. Discussions focused, primarily, around the theme of ‘complexity’, in terms of multimorbid patients, biopsychosocial factors driving prevention and outcomes, the sectors that need to align to treat, and the research methods and data to adequately stratify and capture effects. We included 31 questions in round one of the Delphi. 27 of the 50 round one invitees responded (54% response rate), and 24 of the 27 to round two (89% follow-up rate). 10 questions reached final consensus for research prioritisation. The final list of prioritised questions can broadly be grouped into two, (i) questions relating to new and adapted models of care, and (ii) questions relating to new and adapted research methods and data. Those dealing with models of care tended to have a higher proportion of respondents endorsing prioritisation.

Consequences

These priorities offer funders and researchers a basis upon which to build future grant calls and research plans. Avoiding complexity, both in practice and in research design, is likely no longer an option for improving our systems of care and particularly, for prevention of disease.

Submitted by:

Jonathan Stokes

Funding acknowledgement:

This research was funded by the National Institute for Health and Care Research (NIHR) School for School for Primary Care Research (SPCR). The views expressed are those of the authors and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care.