A team of researchers has developed a new model of care for persons 50 years and above who live with multiple chronic health conditions to help improve their quality of life.
The chronic conditions include diabetes, hypertension, heart disease, arthritis and respiratory disorders.
Focused on Africa, the team developed the model – Theory of Change – around the findings of a research conducted to identify gaps in primary palliative care for the ageing population who are confronted with multiple chronic conditions.
The research, conducted in Ghana, Malawi and Zimbabwe on the topic, “Multimorbid Ageing Primary Palliative Care”, was also to find out how to improve on such care in terms of staff workforce capacity and patients’ families.
The local team was led by a Senior Specialist, Family and Palliative Physician, Dr Edwina Beryl Addo Opare-Lokko, who is also the National Coordinator for the Modular Family Medicine Membership Training Coordinator at the Ghana College of Physicians and Surgeons.
Other collaborators included King’s College, London; the Kwame Nkrumah University of Science and Technology, and the Ghana College of Physicians and Surgeons.
The 18 months’ study, which was completed in March this year, was funded by the Medical Research Council (MRC).
Presenting portions of the study at a meeting in Accra last Thursday, Dr Opare-Lokko from the Department of Family Medicine of the Greater Accra Regional Hospital, said those chronic conditions interacted with each other, leading to complex health challenges which required a more human-centred holistic, unique care.
She said multimorbid ageing could pose significant medical, psychological and social challenges for both the affected individuals and their healthcare providers.
“Integrating primary palliative care principles into the care of older adults experiencing multimorbid ageing can enhance their quality of life, promote effective symptom management and facilitate important conversations about care preferences and goals.
“It requires a collaborative and multidisciplinary approach among healthcare providers, caregivers and patients to provide comprehensive and compassionate care,” she said.
Another member of the team, Dr Adwoa Bemah Boamah Mensah, said the new model of care was piloted in two facilities, the Tetteh Quarshie Memorial Hospital and the Mamprobi Government Hospital, after a series of capacity-building and mentorship programmes for selected health professionals.
She said mentees welcomed the intervention and proposed that training and mentorship should also target all departments as communication was universal, irrespective of the unit.
“The training and mentorship has transformed the way they are managing patients now.
They think that patients can attest to this.
“They would like this mentorship to continue even after the MAPCare Programme.
They are also of the view that the classroom training should have been extended; two days was not enough to capture and internalise everything,” she said.
Present at the meeting included representatives of the Ministry of Health, the Ghana College of Physicians and Surgeons, the Ghana Health Service, who applauded the model and recommended that it be replicated nationwide in all health facilities to enhance health outcomes.
Introducing the study for dissemination, another team member and the overall lead investigator, Dr Kennedy Nkhoma, said it had been established that each year, an estimated 61 million people experienced serious health-related suffering (SHS) towards the end of their lives.
He said 80 per cent of older people lived in low and middle-income countries (LMICs), while access to palliative care remained poor in such countries.
Objectives of the study included establishing an African patient and public involvement palliative care network to inform research procedures and dissemination, determine primary care staff, patient and family views of costs, barriers, facilitators and necessary support to achieve primary person-centred palliative older care for multimorbid serious illness and to develop a logic model and novel model of care to integrate value-based care, patient-centred outcome measurement, a decision support tool and staff mentorship.
Among the findings of the study are the long hours the aged living with multiple chronic conditions spend at the hospitals to access care.
The elderly who participated in the study recommended an appointment system in healthcare delivery.