Multi-morbidity - health related Multi-morbidity - relevant to daily life
Conditions
Interventions
Group 1: 817 multimorbid patients cared for by an APN over a 12-month period (intervention group)
total intervention period: 24 months
patient recruitment: successive, first patient in: 01/10/2021
last patient in: 31/03/2023.
Design intervention group: GP-oriented care of multimorbid patients by APNs, qualification profile of APNs: nursing professional license, at least 2 years of professional
task profile: in-depth assessment, preparation, monitoring and evaluation of a person-centered and evidence-based care plan.
Group 2: 1,634? multimorbid patients receiving standard care (control group
Sponsors
Katholische Hochschule Mainz
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Medical diagnosis of at least three chronic diseases, which in the past 12 months in at least three out of four quarters have given rise to family practitioners treatment, minimum age 18 years, in general practitioners treatment, , insurance with a statutory health insurance company
Exclusion criteria
Exclusion criteria: not fulfilling the inclusion criteria, in the dying phase according to the assessment of the general practitioner
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| use of other institutions; measurement instrument: project-specific data set description; measurement time points: continuous data collection | — |
Primary
| Measure | Time frame |
|---|---|
| number of emergency contacts ; measurement instrument: project-specific data set description; measurement time points: continuous data collection | — |
Countries
Germany
Contacts
Public ContactRenate Stemmer
Katholische Hochschule Mainz
Outcome results
None listed