Primary healthcare professionals’ competencies needed in the management of integrated and person-centred care for chronic illness and multimorbidity

Abstract

Introduction: The management of chronic diseases and multimorbidity is an important part of primary healthcare. Current disease management programs focus primarily on a single disease, while multimorbidity and social problems often co-occur. Person-centered integrated care delivered by interprofessional collaborative teamwork tailors care to the needs of the individual patient and empowers the patient to become an active participant in his own care. However, it is uncertain how healthcare professionals can be optimally equipped to deliver care and participate as team members in this contemporary approach. Objective: In this review, we explored what competencies primary healthcare professionals need to deliver high-quality person-centered integrated care, and how these competencies can be acquired. Methods: We performed a scoping review guided by the methodological framework proposed by Arksey and O'Malley. Guidelines and chronic disease management programs were searched in the Trip medical database with the following terms including their linguistic variations; a) primary care, b) integrated care, c) chronic illness, d) multimorbidity, e) shared decision making and f) competencies. Next, using the same keywords, we searched for peer-reviewed articles in the following scientific literature databases: Cinahl, Embase, PubMed, Medline, and Web of Science. Grey literature was hand-searched through websites of relevant national and international journals, scanning reference lists and through Google and Google Scholar. All titles and abstracts of both the guidelines and peer-reviewed articles were reviewed against inclusion and exclusion criteria and screened independently by two researchers. Then full text publications were retrieved and synthesized when they met the inclusion criteria. Results: The screening resulted in 17 guidelines and 89 articles to be obtained in full text. After reading full text papers, a total of 4 guidelines and 21 articles met the inclusion criteria and were included in the data synthesis. Next to several subthemes four main themes were identified; interprofessional communication, interprofessional collaborative teamwork, leadership and patient-centred communication. However, all included papers lacked a description of competencies' core concepts, such as knowledge, skills and attitudes necessary for the personcentered integrated care approach or how competencies can be acquired in addition to academic or bachelor professional training. Conclusion: This review provides an integrative view on professionals' competencies necessary for person-centered integrated care within the practice of primary care, though details on competencies' core concepts are lacking. More research is needed, on competencies and educational programs to ensure healthcare professionals in primary care are better equipped to deliver person-centred integrated care for chronic ill patients. [ABSTRACT FROM AUTHOR]