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Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 2010 July 1; 60(576): e285–e294.
PMCID: PMC2894403

GPs' and pharmacists' experiences of managing multimorbidity: a ‘Pandora's box’

Susan M Smith, MSc, MD, MRCGP, Senior Lecturer in Primary Care, Siobhan O'Kelly, MSc, MICGP, Research Fellow, and Tom O'Dowd, MD, FRCGP, Professor of General Practice



Multimorbidity is defined as the occurrence of two or more chronic diseases in one individual. Patients with multimorbidity generally have poorer health and functioning and higher rates of attendance in primary care and specialty settings.


To explore the views and attitudes of GPs and pharmacists managing patients with multimorbidity in primary care.

Design of study

Qualitative study using focus groups.


Primary care in Ireland.


Three focus groups were held in total, involving 13 GPs and seven pharmacists. Focus groups were recorded, transcribed, and analysed using the ‘framework’ approach.


The predominant themes to emerge from the focus groups were: 1) the concept of multimorbidity and the link to polypharmacy and ageing; 2) health systems issues relating to lack to time, inter-professional communication difficulties, and fragmentation of care; 3) individual issues from clinicians relating to professional roles, clinical uncertainty, and avoidance; 4) patient issues; and 5) potential management solutions.


This study provides information on the significant impact of multimorbidity from a professional perspective. It highlights potential elements of an intervention that could be designed and tested to achieve improvements in the management of multimorbidity, outcomes for individuals affected, and the experiences of those providing healthcare.

Keywords: chronic disease, general practice, multimorbidity, qualitative research

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners