Healthcare interventions for the management of the elderly multimorbid patient

Proposals should focus on interventions for effective, integrated patient-centred approaches, to improve the management of multimorbid elderly patients. Proposals should support the delivery of best care adapted to such patients. The patient-centred approach should be holistic, inclusive, cross-sectoral and interdisciplinary. Proposals should aim at improving the quality of life of the elderly patient, by targeting individuals, formal and informal caregivers and simplifying the care pathway of multimorbid patients, including through self-management. Proposals may stratify patients, develop the clinical concept of intrinsic capacity and use social innovation. Proposals should define quality performance indicators for the management of multimorbidity and aim to strengthen cooperation among different health disciplines and medical specialties. Sex and gender differences should be taken into account. Aspects of independent living, fragmentation of treatment, polypharmacy, adherence to treatments may also be addressed. Health economics, cost effectiveness and inequalities should also be addressed.

The Commission considers that proposals requesting a contribution from the EU of between EUR 4 to 6 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts.

It is estimated that more than 50 million European citizens suffer from multimorbidity[[Multimorbidity is defined as coexistence of multiple chronic diseases and medical conditions in the same individual (usually defined as two or more conditions).]]. As the global population continues to grow and age, multimorbidity is increasingly prevalent in elderly[[The elderly population is defined as people aged 65 and over (OECD definition).]] patients.

The management of multimorbid patients presents many challenges for Europe. As healthcare systems remain single-disease focussed, the optimal healthcare pathway for multimorbid patients is very complex. Healthcare costs associated with multimorbidity are high and rising. An estimated 55% of all healthcare costs are due to multimorbidity. Currently, there are limited means to address effectively the complex needs of multimorbid patients and caregivers. There is a lack of best practices. As a result, multimorbid patients suffer from inappropriate interventions, including delays in the care pathway, polypharmacy, adverse drug reactions, or non-adherence to treatments. This leads to a highly negative impact on the quality of life of individuals and is often associated with significant costs, some of which are avoidable.

Actions are expected to contribute to better management of multimorbid elderly patients and cost containment in healthcare interventions by addressing one or more of the following points:

• New validated, patient-oriented and stratified care pathways and healthcare models for the management of multimorbid elderly patients.
• New clinical guidelines and best practices for improved management of elderly multimorbid patients.
• Developed or modified quality key performance indicators for the management of multimorbidity.