Preventing and Managing Multimorbidity by Integrating Behavioral Health and Primary Care

In a commentary published in Health Psychology, Dr. Arlene Bierman, director of AHRQ’s Center for Evidence and Practice Improvement, identifies opportunities to improve health outcomes for the growing number of people at risk for or who have multiple chronic conditions. Multimorbidity, often used synonymously with multiple chronic conditions, refers to people with more than one chronic physical condition, more than one mental health diagnosis or both. It may also include additional factors: disease severity, functional impairments and disabilities, syndromes such as frailty and social factors such as homelessness. The commentary discusses why integrating behavioral health and primary care is essential for improving care for this population and the potential of research to achieve effective strategies for delivering integrated, patient-centered care. Access the abstract

2019 Sep;38(9):851-854. doi: 10.1037/hea0000787.

Preventing and managing multimorbidity by integrating behavioral health and primary care.

Bierman AS.

Abstract

Increasing specialization, underinvestment in primary care and behavioral health, and the growing prevalence of multiple chronic conditions (MCC) across all age groups have led to a substantial mismatch between the way health care is currently organized and delivered and the needs of people with MCC. People with multimorbidity are especially challenged in navigating fragmented health systems designed to treat diseases rather than people. The harms associated with this fragmentation, such as adverse events resulting from conflicting treatments and increased costs, have been well documented. As a result, there have been renewed calls for more patient-centered care, with a particular emphasis on the importance of the integration of primary care and behavioral health as fundamental for achieving this goal. There is an enormous opportunity to improve individual and population health by developing, implementing, evaluating, scaling, and spreading effective interventions to prevent and manage multimorbidity. This will require integration of behavioral health and primary care and broader efforts to create healthy communities, including efforts to address the social determinants of health, as well as the alignment of clinical medicine, public health, and community services to support these efforts. Evidence is needed for the most effective strategies to manage multimorbidity as well as for models of health care delivery and population health to foster health and well-being for all. (PsycINFO Database Record (c) 2019 APA, all rights reserved).