Illness representations in patients with multimorbid long-term conditions: qualitative study

Area of Science:

• Health Psychology
• Qualitative Research
• Patient Experience

Background:

• Most illness representation research focuses on single conditions.
• Multimorbidity, having multiple long-term conditions, is common but understudied in this context.
• The impact of multimorbidity on patient illness representations remains largely unknown.

Purpose of the Study:

• To explore patient representations of multimorbid long-term conditions.
• To assess how illness representation models need modification for multimorbidity.
• To investigate the impact of multimorbidity on individual condition perceptions and the representation of multimorbidity itself.

Main Methods:

• Exploratory qualitative study.
• Interviews conducted with 28 adults experiencing at least two long-term conditions (mean of 4).
• Analysis focused on illness representations across identity, perceived cause, coherence, and consequences.

Main Results:

• Multimorbidity impacts patient perceptions of individual conditions across key dimensions.
• Patient representations of multimorbidity encompass medication burden, condition prioritization, and inter-condition dynamics.
• Synergies and antagonisms between conditions and their management are key concerns.

Conclusions:

• Existing illness representation models may require adaptation for multimorbidity.
• Findings have implications for measuring multimorbidity and designing interventions.
• Improved understanding can enhance health behavior and outcomes for patients with multiple conditions.