Eliciting and prioritising determinants of improved care in Multiple Long Term Health Conditions (MLTC): A modified online Delphi study

Introduction Multiple Long Term Conditions (MLTC) are a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for people living with MLTC. In this study, we aimed to elicit and prioritise determinants of improved care in people with MLTC. Methods A three round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with MLTC and their carers. Results Our findings suggest a care system which is still predominantly single condition focused. ‘Person-centred and holistic care’ and ‘coordinated and joined up care’, were highly rated determinants in relation to improved care for MLTC. We further identified a number of non-medical determinants that are important to providing holistic care for MLTC. Conclusions Further progress towards a holistic and patient centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with MLTC. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.