Establishing integrated care for people with multimorbidity is taking shape slowly

Although people with multiple chronic conditions (multimorbidity) receive integrated care in a number of European countries, the availability of such care is still limited. These integrated care programmes have established a limited level of multidisciplinary care, or focus mainly on people who have been diagnosed with a combination of two specific diseases.

In all European countries, the number of people with multiple chronic conditions is on the rise. According to estimates, 50 million people in Europe are living with multimorbidity. They often require care from various health professionals. Right now, care for those with multimorbidity is fragmented because it is offered in a way that is specific to a certain disease or discipline. When care provided by various health professionals is integrated, it is expected to be more effective and more patient-friendly than fragmented care. As a result, people with multimorbidity will receive higher-quality care.

Current innovations often local or regional
Across Europe, various innovations have been developed to provide integrated care to people with multimorbidity. An inventory of these programmes was compiled as part of the "Innovating care for people with multiple chronic conditions in Europe” project (ICARE4EU). From this inventory, 101 programmes were selected, most of which were organised at the local or regional level.

Collaboration between health professionals
Collaboration between health professionals from various disciplines is often the most important objective of integrated care programmes. Other important goals are to increase patient involvement and improve care coordination. General practitioners (GPs) in particular were frequently involved in these care programmes. According to Iris van der Heide, researcher at the Netherlands Institute for Health Services Research (NIVEL), “Because of their central position within the web of health professionals, it’s often said that GPs can play an important role in integrated care. We also see this reflected in the integrated care programmes of various European countries.”

It appears that when it comes to tailoring care to patient preferences, there is still room for improvement in a number of areas. For example, only half of the programmes were developed with input from patients or representatives acting on the patients’ behalf.

European research
The ICARE4EU project ( aims to improve the care provided to people with multimorbidity in Europe. The project will compile, describe, and analyse information on innovative integrated care programmes for people with multimorbidity in all European Union (EU) countries. NIVEL, who is coordinating the project, is working alongside the Italian National Institute of Health and Science on Aging (INRCA), the Technische Universität Berlin (TUB), the University of Eastern Finland (UEF), and the University of Warwick in the United Kingdom. The project is co-funded by the 2nd Health Programme (2008-2014) of the European Union.