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BMC Primary Care
Published in: BMC Primary Care 1/2019

Open Access 01-12-2019 | Care | Research article

A multidisciplinary self-management intervention among patients with multimorbidity and the impact of socioeconomic factors on results

Authors: Éric Contant, Christine Loignon, Tarek Bouhali, José Almirall, Martin Fortin

Published in: BMC Primary Care | Issue 1/2019

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Abstract

Background

Limited studies exist on successful interventions for patients with multimorbidity. Even more limited is the knowledge on how socioeconomic factors have an impact on these interventions. The objective of this study was to analyze the effect of a multidisciplinary self-management intervention among patients with multimorbidity and the impact of socioeconomic factors on the results.

Methods

Secondary data analysis limited to multimorbid patients from of a pragmatic randomized trial evaluating an intervention that included patients (18 to 75 yrs.) from eight primary care practices in Quebec, Canada. The intervention included self-management support and patient-centred motivational approaches. Self-management was evaluated using the Health Education Impact Questionnaire (heiQ) which measures eight different domains. Changes in heiQ were analyzed following the three-month intervention with univariate and multivariate logistic regressions.

Results

Participants with three or more chronic conditions (n = 281), randomized to intervention or control groups, were included in this analysis. The effect of the intervention on the likelihood of an improvement in self-management was significant in six heiQ domains in the univariate analysis (Odd ratio; 95% CI): Health-directed behaviour (2.03; 1.16–3.55), Emotional well-being (1.97; 1.05–3.68), Self-monitoring and insight (2.35; 1.02–5.40), Constructive attitudes and approaches (2.91; 1.45–5.84), Skill and technique acquisition (1.96; 1.13–3.39), and Health services navigation (2.52; 1.21–5.21). After controlling for age and gender the results remained essentially the same. After additional adjustments for family income, education and self-perceived financial status, the likelihood of an improvement was no longer significant in the domains Emotional well-being and Self-monitoring and insight.

Conclusions

The intervention produced significant improvements in multimorbid patients for most domains of self-management. Socioeconomic factors had a minor impact on the results.

Trial registration

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Metadata
Title
A multidisciplinary self-management intervention among patients with multimorbidity and the impact of socioeconomic factors on results
Authors
Éric Contant
Christine Loignon
Tarek Bouhali
José Almirall
Martin Fortin
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
BMC Primary Care / Issue 1/2019
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-019-0943-6

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