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We’ve published new research using the 2018 GP patient survey on whether the needs of patients with multiple long-term conditions are being met, both in general practice and by local services (e.g. support groups, charities, pharmacies)... results unravelled in this thread 
1. Unmet need in general practice - patients with multiple long-term conditions (LTCs) were less likely to have their needs were fully met compared to patients with 1 LTC, but once sociodemographic and health status were accounted for, this relationship was no longer seen.
2. Unmet need through local services - patients with more LTCs were less likely to feel supported by services in their local area compared to patients with 1 LTC, even when adjusting for sociodemographic and health status.
3. When looking at patients with at least 2 LTCs, those who were younger (aged 16-24), Asian, had a lot of difficulties with activities of daily living or reported that they felt isolated were least likely to feel that their needs were met (both in GP and local services).
4. Variation between GP practices and local authorities accounted for v small variation in unmet need (both in general practice and from local services), but the size of the practice showed a strong effect - those from bigger practices were less likely to have their needs met.
The level of unmet need amongst patients with multiple conditions is concerning, and there are challenges with meeting these needs. Treatments focussed on single conditions can actually be v burdensome for those with multiple conditions.
It’s been recommended to offer patients with multiple conditions longer appointment times, as well as allowing them to see the same GP, but this is slightly at odds with improving primary care access through e.g. larger practices.
And what of COVID-19? Certainly the pandemic has exacerbated the challenges already faced by those with multiple LTCs. Access to their normal services has been reduced and many have been isolating from friends and family. Important to get initiatives right for these patients...
...and to be able to demonstrate their effectiveness (e.g. personalised care) in order to understand how best to deliver care to them, especially now, given the additional physical and mental distress that the pandemic has caused.
Link to the full paper here: https://bmjopen.bmj.com/content/10/11/e041569.full
Special thanks to @SarahScobie2 @eiliskeeble & @CAM_Paddison for being such great (and patient!) colleagues to work with as I battled with making sense of MANY logistic regression models.
Special thanks to @SarahScobie2 @eiliskeeble & @CAM_Paddison for being such great (and patient!) colleagues to work with as I battled with making sense of MANY logistic regression models.
And you can read the headlines from our paper in a new blog from me & @SarahScobie2 here: https://www.nuffieldtrust.org.uk/news-item/are-the-needs-of-people-with-multiple-long-term-conditions-being-met#peoples-needs-are-not-being-fully-met-by-their-local-services
