General practitioner strategies for managing patients with multimorbidity: a systematic review and thematic synthesis of qualitative research
General practitioners (GPs) increasingly manage patients with multimorbidity but report challenges in doing so. Cancer patients in particular, have issues managing their multimorbidities, especially if their health conditions are treated separately and not holistically. This systematic review aimed to understand how multimorbidity impacts GPs, the strategies employed to manage challenges, and what must be addressed to ensure quality patient care. Three major challenges were identified: (1) practising without supportive evidence; (2) working with health care system which focuses around a single condition and specialisation; (3) the uncertainty associated with multimorbidity complexity and GP’s perceptions of decisional risk. Three approaches were utilised to mitigate these challenges: (1) prioritising patient-centredness and relational continuity; (2) relying on knowledge of patient preferences and unique circumstances to individualise care; (3) and structuring the consultation to create a sense of time and minimise patient risk. Going forth, GPs described a need for better multimorbidity management guidance to ensure quality patient care.