出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : Several countries have gradually begun to develop and implement integrated care pathways for patients with multimorbidity. It is a goal of health authorities to increase patient involvement. However, more knowledge is needed about how to involve patients in such complex care pathways. Methods : We searched Scopus and CINAHL to answer the following: Which knowledge and topics on involvement of patients with multimorbidity do we find in the scientific literature? We examined articles through the years 2010 – 2017, and conducted thematic content analysis to identify main themes. Results : We retrieved 59 articles and 17 were eventually included. Our analysis revealed that the literature centralized on three major themes: 1 Involvement in medication. Interprofessional collaboration is needed because of polypharmacy and diseasespesific guidelines. But it is important to get thorough information about the patient and include patient`s preferences in the prescribing process. 2 Involvement through education. Self-management support programs should be based on patients`personal goals. Healthcare professionals need more education in how to involve patients. 3 Involvement of personal values and needs. The literature describes areas in wich it is advisable to ask patients about their values. Understanding patients`values is improving the development, sharing and following up of care plans. Discussion : Results indicate need for more patient involvement within all these areas, and that education programmes aimed at these patient groups and health professionals can help. The strength of the study is that it reveals areas that have been researched, and implicit illuminates unexplored areas. Unexpectedly, few studies have looked at patient involvement from the patient perspective throughout the entire care pathway. Conclusions : The findings can be useful to improve integrated care pathways and promote involvement for this patient group. Limitations : We limited our search to scientific articles in English and in two databases, which is a limited set of data. We did not distinguish between qualitative or quantitative studies in the selection of articles. Suggestions for future research : Some of the education programs aimed at patients with multimorbidity should be validated and evaluated.
关键词：multimorbidity ; patient involvement ; integrated care pathways ; literature review ; primary care
