Care Coordination Improves Health of Older Adults With Multiple Chronic Diseases

A study published in the Canadian Medical Association Journal found care coordination appears to have the biggest impact on the improved health of older adults with multiple chronic diseases, reports EurekAlert . The researchers conducted a systematic review of all studies on the topic published between 1990 and 2017, including 25 studies with 12,579 older adults. Care coordination strategies have the greatest potential of improving health in seniors with multiple chronic diseases. In one example, care coordination entailing case management, self-management, and education of recipients and providers significantly mitigated symptoms of depression in adults with combined depression and chronic obstructive pulmonary disease or in those with combined diabetes and heart disease. "Our study highlights the lack of interventions specifically focused on managing co-existing chronic illnesses in older adults, especially those that appear in clusters, such as diabetes, depression, heart disease, and chronic obstructive pulmonary disease," says the University of Toronto's Monika Kastner. "Depression is common in those with diabetes and, because each can be a risk factor for the other, self-care and taking medications correctly can be challenging for improved health." The researchers note clinical guidelines usually concentrate on a single disease, so management of multimorbidity can be overwhelming for recipients and difficult for providers due to the complexity of overlapping or conflicting treatments with potential negative interactions. They suggest interventions to manage multiple chronic diseases should not only focus on clinical aspects of care, but also consider recipients' health priorities and goals and their social and emotional well-being.