Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study

Multimorbidity poses significant challenges for patients and healthcare systems, often exacerbated by fragmented care and insufficient collaboration across providers. Blended Collaborative Care (BCC) is a promising strategy to address care complexity by partnering care managers (CMs) with primary ca...

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Main Authors: Josefine Schulze, Dagmar Lühmann, Jonas Nagel, Cornelia Regner, Christine Zelenak, Kristina Bersch, Christoph Herrmann-Lingen, Matthew M. Burg, Birgit Herbeck-Belnap
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Behavioral Sciences
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Online Access:https://www.mdpi.com/2076-328X/15/1/79
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author Josefine Schulze
Dagmar Lühmann
Jonas Nagel
Cornelia Regner
Christine Zelenak
Kristina Bersch
Christoph Herrmann-Lingen
Matthew M. Burg
Birgit Herbeck-Belnap
author_facet Josefine Schulze
Dagmar Lühmann
Jonas Nagel
Cornelia Regner
Christine Zelenak
Kristina Bersch
Christoph Herrmann-Lingen
Matthew M. Burg
Birgit Herbeck-Belnap
author_sort Josefine Schulze
collection DOAJ
description Multimorbidity poses significant challenges for patients and healthcare systems, often exacerbated by fragmented care and insufficient collaboration across providers. Blended Collaborative Care (BCC) is a promising strategy to address care complexity by partnering care managers (CMs) with primary care providers (PCPs) and specialists. This study aimed to adapt and pilot a BCC intervention for patients aged 65+ with heart failure and physical–mental multimorbidity. Our objectives were to assess the feasibility of the study procedures, patient recruitment, participant satisfaction and acceptability, and to identify necessary adjustments for improving intervention delivery. We evaluated goal attainment and intervention fidelity through standardised electronic documentation by CMs, and patient acceptance and satisfaction through semi-structured interviews. A monocentric, one-arm pilot study involved nine patients with a mean of 6.7 contacts with their CM over three months. Patients’ health goals primarily focused on lifestyle changes and psychosocial support. The intervention was generally well-accepted, with no reported negative consequences. Difficulties in establishing working alliances with PCPs were a barrier to effective implementation. The analysis indicated the need for minor procedural adjustments. Next steps include launching the ESCAPE trial, a large randomised-controlled trial across different European healthcare systems and developing strategies to facilitate PCP involvement.
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institution Kabale University
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spelling doaj-art-a85d5be834154b88a960df7059afe9da2025-01-24T13:22:50ZengMDPI AGBehavioral Sciences2076-328X2025-01-011517910.3390/bs15010079Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot StudyJosefine Schulze0Dagmar Lühmann1Jonas Nagel2Cornelia Regner3Christine Zelenak4Kristina Bersch5Christoph Herrmann-Lingen6Matthew M. Burg7Birgit Herbeck-Belnap8Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37073 Göttingen, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37073 Göttingen, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37073 Göttingen, GermanyClinical Trials Unit, University Medical Center Göttingen, 37075 Göttingen, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37073 Göttingen, GermanySection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT 06520, USADepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37073 Göttingen, GermanyMultimorbidity poses significant challenges for patients and healthcare systems, often exacerbated by fragmented care and insufficient collaboration across providers. Blended Collaborative Care (BCC) is a promising strategy to address care complexity by partnering care managers (CMs) with primary care providers (PCPs) and specialists. This study aimed to adapt and pilot a BCC intervention for patients aged 65+ with heart failure and physical–mental multimorbidity. Our objectives were to assess the feasibility of the study procedures, patient recruitment, participant satisfaction and acceptability, and to identify necessary adjustments for improving intervention delivery. We evaluated goal attainment and intervention fidelity through standardised electronic documentation by CMs, and patient acceptance and satisfaction through semi-structured interviews. A monocentric, one-arm pilot study involved nine patients with a mean of 6.7 contacts with their CM over three months. Patients’ health goals primarily focused on lifestyle changes and psychosocial support. The intervention was generally well-accepted, with no reported negative consequences. Difficulties in establishing working alliances with PCPs were a barrier to effective implementation. The analysis indicated the need for minor procedural adjustments. Next steps include launching the ESCAPE trial, a large randomised-controlled trial across different European healthcare systems and developing strategies to facilitate PCP involvement.https://www.mdpi.com/2076-328X/15/1/79heart failuremultimorbiditypsychological distressintegrated carecare managementpatient-centred care
spellingShingle Josefine Schulze
Dagmar Lühmann
Jonas Nagel
Cornelia Regner
Christine Zelenak
Kristina Bersch
Christoph Herrmann-Lingen
Matthew M. Burg
Birgit Herbeck-Belnap
Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study
Behavioral Sciences
heart failure
multimorbidity
psychological distress
integrated care
care management
patient-centred care
title Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study
title_full Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study
title_fullStr Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study
title_full_unstemmed Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study
title_short Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study
title_sort adapting and implementing a blended collaborative care intervention for older adults with multimorbidity quantitative and qualitative results from the escape pilot study
topic heart failure
multimorbidity
psychological distress
integrated care
care management
patient-centred care
url https://www.mdpi.com/2076-328X/15/1/79
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