Multidisciplinary assessment guideline for multimorbidity published

The newly published guideline Multidisciplinary Assessment for Multimorbidity introduces a new outpatient consultation structure. The aim of the guideline is to contribute to improving the quality of care for the large group of patients with multiple chronic conditions.

These patients often involve multiple healthcare providers within the hospital who – separately – treat the individual diseases, often referred to as fragmentation of care. Fragmentation of care can have negative consequences such as under- and over-treatment, complications due to interacting diseases and treatments, and high healthcare use. The increase in patients with multiple chronic conditions is one of the most important demographic developments of the moment, and therefore an important challenge for healthcare.

The guideline takes an important and ambitious step to improve the quality of care for this patient group by pursuing an overarching and coordinated treatment. An overarching and coordinated treatment means that the treatment as a whole is better tailored between the different practitioners and to the individual situation of the patient and to his or her goals, preferences and possibilities. This will lead to better coordination of care and the application of the right care. To arrive at such a treatment plan, multidisciplinary consultation and cooperation is necessary, and this is embodied in the Multidisciplinary Assessment of Multimorbidity (MDB).

The guideline, which is primarily intended for medical specialists in secondary care who care for patients with multiple chronic conditions and secondarily for policy makers, provides tools to recognize the right target group and to organize an MDB. It is important to note that the guideline is not intended as an obligation, but rather as an incentive to reflect on the problem and start to improve the care of patients with multiple chronic conditions. In order to properly enable multidisciplinary assessment of patients with multimorbidity, it is also essential that the right preconditions are in place. Healthcare is currently organized in such a way that implementing such a form of care is very difficult. Providing space to organize a consultation structure for patients with chronic multimorbidity should be achieved jointly with relevant stakeholders.

Cooperation

The guideline was drawn up at the initiative of the Dutch Internists Association (NIV), by a multidisciplinary committee with representatives from: pulmonologists (NVALT), rehabilitation physicians (NVR), cardiologists (NVC), surgeons (NVH), clinical geriatricians (NVKG), psychiatrists. (NvVP), hospital pharmacists (NVZA), nurses (V&VN) and the Netherlands Patient Federation. The Knowledge Institute of the Federation of Medical Specialists supervised the process. Financing comes from the Foundation for Quality Funds for Medical Specialists (SKMS).

View the guidance