Indicators of care improved by 3D reviews

Reviews of older people with multiple conditions using a 3D approach did not improve their quality of life but gave better indicators of patient-centred care

Primary care nurses often manage patients with long-term conditions but focus on single conditions.

However, many older adults have multiple chronic conditions. This cluster-randomised trial in 33 general practices in England and Scotland investigated whether a patient-centred, 3D approach – based on dimensions of health, depression and drugs – for people with multiple conditions would improve quality of life.

In the intervention practices, 797 patients (of a total 1,546) were invited to one six-monthly comprehensive multidisciplinary review rather than, as in the control practices, the usual care involving multiple single-disease review appointments.

What the review included

Each 3D review included time with a nurse to identify problems that bothered patients the