Tohoku J. Exp. Med., 2024 October, 264(2)

Background Factors that Hospital-Based Geriatricians and General Practitioners Associate with Difficulty in Treating Older People with Multimorbidity: A Cross-Sectional Survey

Takuma Kimura,¹ Shinji Matsumura,² Masayoshi Hashimoto¹ and Ken Shinmura³

¹Department of R&D Innovation for Home Care Medicine, Department of General Medicine, Institute of Science Tokyo, Tokyo, Japan
²Matsumura Clinic/Division of Clinical Epidemiology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
³Department of General Internal Medicine, Hyogo Medical University, School of Medicine, Nishinomiya, Hyogo, Japan

In recent years, hospital-based geriatricians and general practitioners in Japan who frequently manage older people with multimorbidity in an acute setting have often found treating these patients difficult. In this study, we surveyed geriatricians and general practitioners who treat older people with multimorbidity in hospitals to identify patient characteristics that make treatment provision difficult in these patients. In June 2022, we mailed an anonymous questionnaire to 3,300 family medicine specialists, primary care-certified physicians, and geriatric specialists in Japan. We used a four-point Likert-type scale to score items specific to diseases, patient backgrounds, clinical factors, and important clinical strategies that make treatment provision difficult. We used logistic regression analysis to identify factors that hospital-based geriatricians and general practitioners associate with difficulty in treating older adults with multimorbidity. In total, 490 cases were included in the analysis. The factors that were associated with difficulty in treating older people with multimorbidity were experience as a physician (adjusted odds ratio [AOR]: 0.935; 95% confidence interval [95% CI]: 0.905-0.965), the overall scores for difficult disease (AOR: 1.028; 95% CI: 1.004-1.053) and difficult background (AOR: 1.065; 95% CI: 1.005-1.129), and the lack of emphasis on general practice guidelines (AOR: 2.91; 95% CI: 1.305-6.491). To facilitate the treatment of older people with multimorbidity, it is desirable to enhance education and training and strengthen support systems within Japan's healthcare system based on the characteristics of hospital physicians who find treating these patients difficult.

Key words —— geriatrician; multimorbidity; older adults; practice guideline; primary care physician

© 2024 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2024 October, 264(2), 61-72.

Correspondence: Takuma Kimura, Department of R&D Innovation for Home Care Medicine, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.

e-mail: kimura.takuma@tmd.ac.jp