Challenges for co-morbid chronic illness care and policy in Australia: A qualitative study

Tanisha Jowsey*, Yun Hee Jeon, Paul Dugdale, Nicholas J. Glasgow, Marjan Kljakovic, Tim Usherwood

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

51 Citations (Scopus)

Abstract

Background: In response to the escalating burden of chronic illness in Australia, recent health policies have emphasised the promotion of patient self-management and better preventive care. A notable omission from these policies is the acknowledgment that patients with chronic illness tend to have co-morbid conditions. Our objectives were: to identify the common challenges comorbidity poses to patients and carers in their experiences of self-management; to detail the views and perceptions of health professionals about these challenges; and to discuss policy options to improve health care for people with co-morbid chronic illness. The method included semistructured interviews and focus groups with 129 purposively sampled participants. Participants were people with Type 2 diabetes, chronic obstructive pulmonary disease and/or chronic heart failure as well as carers and health care professionals. Content analysis of the interview data was conducted using NVivo7 software. Results: Patients and their carers found co-morbidity influenced their capacity to manage chronic illness in three ways. First, co-morbidity created barriers to patients acting on risk factors; second, it complicated the process of recognising the early symptoms of deterioration of each condition, and third, it complicated their capacity to manage medication. Conclusion: Findings highlight challenges that patients with multiple chronic conditions face in relation to preventive care and self-management. Future clinical policy initiatives need to move away from single illness orientation toward strategies that meet the needs of people with comorbid conditions and strengthen their capacity to self-manage. These patients will benefit directly from specialised education and services that cater to the needs of people with clusters of comorbidities.

Original languageEnglish
Article number22
JournalAustralia and New Zealand Health Policy
Volume6
Issue number1
DOIs
Publication statusPublished - 8 Sep 2009
Externally publishedYes

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