Effectiveness of a case management model for people with multimorbidity: Mixed methods study

Area of Science:

• Health Services Research
• Nursing
• Public Health

Background:

• Multimorbidity presents complex challenges for patients and caregivers.
• Existing health systems in Bogotá face access barriers and fragmentation.
• A comprehensive case management approach is needed for patients with multiple chronic conditions.

Purpose of the Study:

• To evaluate a case management model's impact on health service utilization, polypharmacy, quality of life, and dependency in multimorbid patients.
• To assess the model's effect on family caregiver overload.
• To explore patient and caregiver experiences with the case management intervention.

Main Methods:

• Mixed-methods study integrating quantitative (pre-experimental, pre- and post-test) and qualitative components.
• Included 317 patients with multimorbidity and their caregivers in Bogotá.
• Utilized interviews with 17 patient-caregiver dyads and six nurse managers for in-depth understanding.

Main Results:

• Significant improvements in quality of life, particularly social functioning and mental health.
• Reduced caregiver overload and enhanced role adoption observed.
• Positive impact on psychosocial dimensions of health-related quality of life and dependence.

Conclusions:

• The five-module case management intervention effectively addresses complex patient needs.
• Nurse managers play a crucial leadership role in coordinating care and overcoming barriers.
• The model offers valuable evidence for developing integrated care plans for multimorbid patients and their caregivers, improving trust in the health system.