{
  "abstract": "Background Living with multiple long-term conditions (MLTCs) (multimorbidity) is associated with many challenges. A previous qualitative evidence synthesis generated eight themes of ‘work’ that represent these challenges. Each theme contained many constituent concepts, each representing an aspect of work. We aimed to achieve consensus on which of these work concepts were considered important by people living with MLTCs and carers (PCs), and by health professionals and researchers with MLTC expertise (HRs). We also asked HRs which of these work concepts would be coded in, or could be calculated from, electronic healthcare records.Methods Modified Delphi study comprising two rounds. Surveys were designed using Qualtrics. We recruited participants using non-probability purposive sampling via academic, PPI (Patient and Public Involvement) and informal networks and adverts. 103 concepts across eight work themes (symptom work, emotional work, health service and administration, financial work, learning and adapting, investigation and monitoring, medication work and accumulation and complexity) were ranked for importance and likelihood of coding. The consensus level was set at 75%.Results 24 PC and 20 HR participants participated in round one, with 20 (83%) of PCs and 18 (90%) of HRs also completing round 2. PCs agreed that 101/103 (98%) concepts were important. HRs agreed that 102/103 (99%) were important, and 100/103 (97%) were agreed by both groups. Only 23 of 101 (23%) concepts considered important to PCs were considered likely to be coded by HRs.Conclusion PCs and HRs both agreed that the work represented by the vast majority of concepts was important. These concepts should therefore be included in future studies assessing the impact of MLTCs. However, many of these concepts are unlikely to currently be routinely coded in, or calculable from, routine electronic health records. More work is needed to embed this patient-centred approach to support people living with MLTCs.",
  "authors": [
    {
      "affiliations": [
        "School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK"
      ],
      "name": "Emilia Holland"
    },
    {
      "affiliations": [
        "School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Sara Macdonald"
    },
    {
      "affiliations": [
        "Patient and Public Involvement and Engagement, University Hospital Southampton NHS Foundation Trust, Southampton, UK"
      ],
      "name": "Kelly Sum Yuet Cheung"
    },
    {
      "affiliations": [
        "School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK",
        "NIHR Applied Research Collaboration, Wessex, Southampton, UK"
      ],
      "name": "Sebastian Stannard"
    },
    {
      "affiliations": [
        "School of Life Course and Population Sciences, King’s College London, London, UK"
      ],
      "name": "Mark Ashworth"
    },
    {
      "affiliations": [
        "School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK"
      ],
      "name": "Charlotte Gooding"
    },
    {
      "affiliations": [
        "School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK"
      ],
      "name": "Nick A Francis"
    },
    {
      "affiliations": [
        "School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Frances S Mair"
    },
    {
      "affiliations": [
        "School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK",
        "NIHR Applied Research Collaboration, Wessex, Southampton, UK",
        "University Hospital Southampton NHS Foundation Trust, Southampton, Southampton, UK"
      ],
      "name": "Nisreen Alwan"
    },
    {
      "affiliations": [
        "School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK",
        "NIHR Applied Research Collaboration, Wessex, Southampton, UK"
      ],
      "name": "Simon Fraser"
    }
  ],
  "title": "P06-7 Building consensus on patient-centred work concepts in multiple long-term conditions using the modified delphi technique",
  "uid": "485d0c15-6d53-565c-8fcd-39e1b0a9057c"
}