What 'hassles' do patients with multimorbidity report? Which patients report the most 'hassles'?

What ‘hassles’ do patients with multimorbidity report, and which patients report the most ‘hassles’? Objectives:A major problem in current primary care is that services are set up for single long term conditions, whereas many older patients have more than one. Qualitative research suggests that patients experience ‘hassles’ in their care, including multiple appointments, poor co-ordination, and conflicting recommendations. However, there is limited quantitative evidence on the hassles that patients experience, or factors predicting hassles. Methods:The OPTIMUM study surveyed 1500 patients with multimorbidity from 4 large practices in Greater Manchester. Patients completed measures including demography, multimorbidity and ‘hassles’ using the Parchman scale.Results:Overall, 32% of patients completed the measures. The most frequently reported hassles related to lack of information and poor communication, as well as poor access to specialist care. In multivariate analysis, self-reported numbers of long-term conditions, current employment, and symptoms of depression predicted high levels of hassles. Reports of a discussion with the GP about their conditions in the last 12 months and increasing age were associated with lower reported hassles.Conclusion:As expected, increasing numbers of long-term conditions were associated with increasing reports of hassles. It is not clear whether the associations with depression and age represent reporting issues, or more clinically important effects. The study did suggest that frequent discussions with the GP may be important in reducing perceptions of hassles. New models of service delivery need to be tested to improve the experience of patients with multimorbidity.