Making sense of multiple illnesses: a systematic review and meta-synthesis of patient experiences of multimorbidity

Abstract

Background: Multimorbidity is becoming increasingly prevalent. The aim of this study is to explore how patients make sense of and manage multimorbidity through a systematic review and meta-synthesis of qualitative studies. Methods: Electronic databases were searched using multiple condition and qualitative methodology search terms. Findings from included studies were synthesised using the meta-ethnographic approach described by Noblit and Hare. Findings: Thirty four studies were identified for inclusion. A desire to “live a normal life†was a key focus identified across studies. Patients’ attempts to regulate health were hampered by escalating and interacting physical limitations, complex medicine regimes and difficulties in negotiating healthcare systems. Strategies to manage multimorbidity included adapting daily routines, engaging with life and, for older adults, framing multimorbidity as a normal part of the aging. Discussion: As per the Common-Sense Model, patients’ experience of multimorbidity can be understood as the attempt to negotiate health threats and restore normal functioning. However, given the single condition focus in the literature to date, further work is required to extend the model for application in the context of multimorbidity.