Abstract Body

Background

In the Netherlands patients with chronic disease like diabetes, COPD and cardiovascular diseases are treated in single disease oriented chronic disease management programs, while personalised care is getting increasingly important. Last year we developed an integrated personalised care program for these chronic diseases. All patients with multimorbidity are offered a generic person-centered consultation with their general practitioner. Patients prepared this consultation with a generic toolkit, based on several domains of health and wellbeing. This preparation stimulates patient empowerment and shared decision making; patient and GP set goals together for the next year.

Aim

In this workshop we share our experiences with personalised care in patients with multimorbidity.

Learning objectives

After this workshop the participant:

Knows how to organize chronic disease management in a personalised way

Knows several methods to stimulate patient’s participation, empower patients and discuss several domains of health and wellbeing

Can use the ‘generic toolkit’, the ‘four domains model’ or the ‘positive health spider web’ to have a personalised multidimensional consultation

Knows how to evaluate patient activation and illness perception with validated instruments

Methods and timetable

15 minutes: Background and presentation of our results (plenary introduction)
60 minutes: In four subgroups three methods for a personalised care consultation will be introduced and methods to measure effects of
this personalised care. Each participant will participate in each subgroup ( 4 x 15 minutes)
15 minutes Summary and definition of take home messages

Results/Conclusions

This workshop will provide insight into possibilities of a new method for personalised care for patients with multimorbidity. Tips and tricks will be shared.