Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study

Glenn Simpson, Beth Stuart, Marisza Hijryana, Ralph kwame Akyea, Jonathan Stokes, Jon Gibson, Karen Jones, Leanne Morrison, Miriam Santer, Michael Boniface, Zlatko Zlatev, Andrew Farmer, Hajira Dambha-Miller

Research output: Contribution to journalArticlepeer-review


Background: Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions.
Methods: A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers.
Results: Our findings suggest a care system which is still predominantly single condition focused. ‘Person-centred and
holistic care’ and ‘coordinated and joined up care’, were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort.
Conclusions: Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.
Original languageEnglish
JournalJournal of Multimorbidity and Comorbidity
Publication statusPublished - 5 Sept 2023


  • Multimorbidity
  • Delphi study
  • integrated care
  • personalised care


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