Table 5.
Final consensus results from round 3.
| No. | Priority Determinants | Median score | Numbers (%) of participants who rated 6 (very important) or 7 (extremely important) N=20 | Consensus level and priority rating of factors for addressing care need in multimorbidity | Ranking position |
|---|---|---|---|---|---|
| 1. | Person-centred and holistic care | 7 | 20 (100) | Very high level of consensus/Very high priority | 1 |
| 2. | Coordinated and joined up care | 7 | 19 (95) | Very high level of consensus/Very high priority | 2 |
| 3. | Flexible systems in place to support people (before ‘cliff-edge’ moments when their conditions or circumstances change)*ˆ | 6 | 18 (90) | Very high level of consensus/Very high priority | 3 |
| 4. | Support for mental health and emotional wellbeing a | 6 | 17 (85) | High level of consensus/High priority | 4 |
| 5. | Data sharing across care services and linked electronic health records | 6 | 17 (85) | High level of consensus/High priority | 4 |
| 6. | Training in multiple long term conditions for healthcare and social care professionals | 6 | 17 (85) | High level of consensus/High priority | 4 |
| 7. | Access to social care, community-based services and other provision | 6 | 17 (85) | High level of consensus/High priority | 4 |
| 8. | Thorough assessment of health and social care needs | 6 | 17 (85) | High level of consensus/High priority | 4 |
| 9. | Early intervention and preventative approach | 6 | 17 (85) | High level of consensus/High priority | 4 |
| 10. | Continuity of care | 6 | 17 (85) | High level of consensus/High priority | 4 |
| 11. | Service availability in terms of timeliness and geography | 6 | 17 (85) | High level of consensus/High priority | 4 |
| 12. | Supporting self-management of conditions | 6 | 16 (80) | High level of consensus/High priority | 5 |
| 13. | Symptom management and monitoring | 6 | 15 (75) | Fairly high level of consensus below threshold | 6 |
| 14. | Prescribing and medication management | 6 | 14 (70) | Fairly level of consensus below threshold | 7 |
| 15. | Inclusive/Equitable service provision | 6 | 14 (70) | Fairly high level of consensus below threshold | 7 |
| 16. | Support with daily living and independent living a | 6 | 14 (70) | Fairly high level of consensus below threshold | 7 |
| 17. | Addressing loneliness and social isolation | 6 | 14 (70) | Fairly high level of consensus below threshold | 7 |
| 18. | Finance/financial assistance | 6 | 13 (65) | Some level of consensus below threshold | 8 |
| 19. | Support provided to informal carers | 6 | 13 (65) | Some level of consensus below threshold | 8 |
| 20. | Access to information for patients and carers and where to go for support | 6 | 12 (60) | Some level of consensus below threshold | 9 |
| 21. | Environmental factors and wider social determinants of health | 6 | 12 (60) | Some level of consensus below threshold | 9 |
| 22. | Able to engage in meaningful activities and social participation a | 6 | 12 (60) | Some level of consensus below threshold | 9 |
| 23. | Recognition of and support with lifestyle factors | 6 | 11 (55) | Some level of consensus below threshold | 10 |
| 24. | Support for children of people living with multiple long term conditions a , b | 6 | 11 (55) | Some level of consensus below threshold | 10 |
| 25. | Housing/accommodation that meets individual's needs | 6 | 11 (55) | Some level of consensus below threshold | 10 |
| 26. | Work issues and training for people living with multiple long term conditions a | 5 | 9 (45) | No consensus | 11 |
| 27. | Enhanced support from family and other informal carers | 5 | 8 (40) | No consensus | 12 |
| 28. | Increasing knowledge and awareness of multiple long term conditions among patients, carers and people in the wider community a | 5 | 8 (40) | No consensus | 12 |
| 29. | Support network | 5 | 7 (35) | No consensus | 13 |
| 30. | More intervention from private care providers a , b | 5 | 6 (30) | No consensus | 14 |
| 31. | Use of technologies to support individuals at home | 5 | 4 (20) | No consensus | 15 |
Factors reached consensus threshold if ≥80% rated, either 6 or 7 on Likert Scale, are shown in bold.
aFactors not aligned with the SELFIE Framework.
bAdditional determinants suggested by respondents in round 2.