Life expectancy in the EU is higher than ever before,  due in part to good and improving healthcare. However, the co-occurrence of multiple chronic conditions in one person, i.e. multimorbidity, has become increasingly common as well. 65% of people over 65 are affected by multimorbidity. This number rises to 85% for the 85-year-old group.

Complex healthcare needs of multimorbid patients require the involvement of a large number of healthcare providers and a vast amount of resources. Often patient care is fragmented, expensive and fails to respond to the needs of the patient. While there are examples of comprehensive care programs being implemented in relatively small populations, there are no widely accepted care models available across the EU Member States, due to organisational differences.

The aim of this JA-CHRODIS work package (WP 6) is to review existing patient-centred comprehensive care programs in order to identify the needs of the participating countries’ healthcare systems. The aim is also to advise on the best possible care models for multimorbid patients, taking into account outcomes, cost-effectiveness, applicability and replicability.


Care Model

Development of a comprehensive care model for multimorbid patients

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Care Approaches

Analyses of national databases, an expert survey and literature review to identify European care approaches for multimorbid patients

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Training Programme

Identification of essential professional competencies and development of training programme for healthcare providers

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Scientific publications

Special Issue on Multimorbidity in the Elderly published on the European Journal of Internal Medicine

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Evaluation of good practices by an expert panel on the basis of outcomes, cost-effectiveness, applicability and replicability

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WP 6 Partners

WP leader and co-leader

Italian Medicines Agency (AIFA), Italy (leader)

Contact: Graziano Onder: [email protected]

Vilnius University Hospital Santariskiu Klinikos (VULSK), Lithuania (co-leader)

Contact: Elena Jurevičienė: [email protected]

Rokas Navickas: [email protected]

Associated Partners

  • Basque Foundation for Health Innovation And Research (BIOEF), Spain
  • European Institute of Women’s Health (EIWH), Ireland
  • European Patients Forum (EPF), Belgium
  • Instituto Aragonés de Ciencias de la Salud (IACS), Spain
  • Institute of Health Carlos III (ISCIII), Spain
  • Ministry of Health and Care Services (HOD), Norway
  • National Center of Public Health and Analyses (NCPHA), Bulgaria
  • National Institute of Health and Welfare (THL), Finland
  • National Institute of Public Health Slovenia (NIJZ), Slovenia
  • Netherlands Institute for Health Services Research (NIVEL), Netherlands
  • 1st PHA of Attica / “Sotiria” Hospital (YPE), Greece
  • Technische Universität Dresden (TUD), Germany
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