The main achievement during 2015 for the JA-CHRODIS work package on multimorbidity was the development of a framework for care of multimorbidity patients that can be applied across Europe.

First, we identified a list of 20 components across five domains from existing published comprehensive care programs for patients with multiple chronic conditions or frailty. An expert meeting was held in Brussels on October 28, to discuss the components. Sixteen were selected after discussion. During the meeting the experts discussed the definition of the components, aims, key characteristics, target population and relevance for patients with multimorbidity in order to develop a framework for care of multimorbidity patients, including recommendations for delivery of system design, decision support, self management support, clinical information systems, and community resources.

An article has been produced to detail the results and conclusions of this meeting, and has been reviewed, edited and, coauthored by all the experts, entitled “Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases (CHRODIS)”.

Downloads

Minutes