Abstract
Background Design and setting patients feel they were being taken more The effectiveness of single disease In 2021, a feasibility study in seven seriously and seen as a unique individual, management programmes in general general practices in the Netherlands and it provided the opportunity to practice may be limited for patients was carried out. The healthcare discuss their life and health concerns. with low socioeconomic status (SES), professionals provided care based on Recommended adaptations of the PC-IC as these programmes insufficiently a PC-IC approach for patients with approach for patients with low SES take into account the specific problems diabetes, chronic respiratory diseases include creating materials that are clear and needs of this population. A and/or cardiovascular disorders. Patients and easy to understand and offering person-centred integrated care (PC- were followed for 6 months. communication training for healthcare IC) approach focusing on individual professionals. Method patient’s needs and concerns could Conclusion address these problems. This was a qualitative study using focus The PC-IC approach seems helpful group discussions, in-depth interviews, Aim for patients with chronic diseases, and semi-structured telephone To explore experiences of patients interviews in a total of 46 patients with provided that it is tailored to their skills with (multiple) chronic diseases with chronic diseases and multimorbidity, and abilities. Several modifications for regard to the acceptability of a general including 31 patients with low SES. patients with low SES were suggested. practice-based PC-IC approach, with Keywords Results a focus on patients with low SES, and general practice; multimorbidity; low to establish which modifications are An overall positive experience of socioeconomic status; multiple chronic needed to tailor the approach to this participants with the PC-IC approach was conditions; patient-centred care; group. observed. Discussing their health made primary health care. Introduction socioeconomic status (SES), defined as obstructive pulmonary disease (COPD) education at basic or lower vocational and increased cardiovascular risk have The increasing prevalence of chronic level (26% of the Dutch adult been introduced in the Dutch general diseases has a huge impact on healthcare population), two to four times more practice to mitigate the impact,6 which systems worldwide.1,2 In the Netherlands, often have chronic diseases than patients are mainly delivered by practice nurses more than 10 million patients (59%) with higher levels of education.5 under supervision of a GP. As half of have chronic diseases such as type 2 the patients had multimorbidity, the diabetes mellitus, chronic respiratory In the Netherlands, the GP is the first diseases, or cardiovascular disorders, contact for health-related issues and the focus on one disease has limitations.7 and half of them have several chronic gatekeeper in the healthcare syste