Shared decision making: A dual-layer model to tackling multimorbidity in primary care

Area of Science:

• Primary Care Medicine
• Health Services Research
• Shared Decision-Making

Background:

• Primary care providers (PCPs) frequently manage patients with complex multimorbidity.
• PCPs face challenges due to short consultation times and limited access to multidisciplinary teams.
• Existing models struggle to address multiple health issues efficiently in primary care.

Purpose of the Study:

• To propose a novel dual-layer shared decision-making (SDM) approach for managing multimorbidity in primary care.
• To enhance the feasibility and time-effectiveness of consultations for PCPs and patients.
• To address the challenges of limited healthcare resources and short consultation durations.

Main Methods:

• A case study in the Malaysian primary care setting.
• Introduction of a dual-layer SDM model involving joint prioritization of diseases (layer 1) and treatments (layer 2).
• Focus on discussion, negotiation, and agreement between PCPs and patients during consultations.

Main Results:

• The proposed dual-layer SDM model facilitates joint decision-making on health priorities.
• It offers a structured approach to tackle complex patient needs within primary care constraints.
• The model aims to improve patient care by ensuring agreed-upon health needs are addressed.

Conclusions:

• The dual-layer SDM approach is a feasible strategy for PCPs managing complex multimorbidity.
• This model optimizes limited consultation time and healthcare resources.
• It empowers patients and PCPs to collaboratively prioritize care, improving health outcomes.