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Current care is inadequate for patients with complicated multimorbidity, and frequently results in fragmented care. There is no widely agreed-upon optimal organisation of healthcare services for this patient group. By drawing upon existing literature and prior studies, we developed a patient-centred complex intervention for multimorbidity CIM and subsequently refined it into CIM version 2 CIM2.
This paper describes the study protocol for a pilot cluster randomised control trail RCT evaluating the effectiveness of a general practice-based intervention. CIM2 aims to support integrated care for patients with complicated multimorbidity.
CIM2 comprises five elements: 1 Training healthcare professionals, 2 an extended overview consultation in general practice, 3 a nurse care coordinator in general practice supporting the planning of the patient trajectory, 4 follow-up care services in general practice, and 5 improving the integration of care between general practice, municipality, and hospital.
Patients are randomly assigned to either the intervention group or the usual care group. Data on chronic conditions, healthcare utilization, and demographic information such as sex, age, and educational attainment will be collected from national registries. The outcome measures will be recorded before, during, and after implementing the intervention.
Qualitative evaluation will include semi-structured interviews with healthcare professionals across various sectors as well as patients. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: No datasets were generated or analysed during the current study.