Effects of a Complex Care Model for Patients with Multimorbidity in Lithuania: Results from an Implementation Study

立陶宛多重疾病患者综合护理模式的效果:一项实施研究的结果

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Abstract

Background/Objectives: Multimorbidity is an increasing challenge in primary care, particularly in aging populations. The aim of the study was to evaluate the effects of a multidisciplinary, patient-centered complex care TELELISPA model on quality of life, mental health, and treatment burden among patients with multimorbidity in Lithuanian primary care settings. Methods: The study was conducted at seven primary healthcare centers in Lithuania and included all TELELISPA project participants who had at least two chronic health conditions including hypertension. Study participants were randomly assigned to intervention (n = 389) and control groups (n = 400): the intervention group received a coordinated, multidisciplinary care intervention for 15 months, whereas the control group received usual care. In the beginning and the end of the study, participants completed different quality of life, treatment burden and psychological health measures. Results: At the 15-month follow-up, the intervention group reported significantly better psychological health scores across different questionnaires-GAD-7 (p = 0.002), PHQ-9 (p < 0.001), EQ-5D-5L anxiety/depression score (p = 0.044), SF-36 emotional well-being score (p = 0.006). The intervention group also had significantly higher overall EQ-5D-5L quality of life scores (p = 0.02), and a better EQ-5D-5L mobility score (p = 0.036). Intervention group patients reported a reduced treatment burden in monitoring health conditions (p = 0.002), obtaining information about their conditions (p = 0.022), and accessing healthcare during the evenings and the weekends (p = 0.003). The interventions were better received by patients who were younger than 65 years of age, while mixed effects were observed between the groups with different numbers of chronic conditions, with or without polypharmacy, and different durations of education. Conclusions: The implementation of a multidisciplinary, team-based complex care model corresponded with improved psychological well-being, enhanced quality of life, and a partially alleviated treatment burden in patients with multimorbidity. The findings of the study support the wider adoption of integrated care models in aging populations and highlight the need for future studies assessing long-term outcomes and cost-effectiveness.

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