Primary care provider perceptions of the challenges of managing patients with mental-physical multimorbidity: a qualitative study

Multimorbidity – the co-occurrence of multiple chronic diseases within a same person – is a common phenomenon in primary care settings. About a third of all primary care patients and the majority of older patients live with multimorbidity, a reality that presents major challenges to primary care providers and the broader healthcare system. The challenges are especially great when patients’ chronic physical diseases are accompanied by mental illness. Such mental-physical multimorbidity profoundly impacts patients’ quality of life and daily functioning and leaves patients at higher risk of receiving lower quality, fragmented care.

In an effort to identify targets for quality improvement for primary care patients with mental-physical multimorbidity, we interviewed 16 primary care professionals and asked them about the features of their practice settings that facilitated or impeded their ability to manage patients with mental-physical multimorbidity. Our findings helped us identify a range of organizational characteristics that were perceived to influence care for these vulnerable patients. The implications of our results for the field of health human resources will be discussed.

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