A win-win approach to more integrated and carer-friendly systems

It is estimated that more than 50 million Europeans suffer from multimorbidity, i.e., live with two or more physical and/or mental health conditions. This number is expected to rise in the near future due to Europe’s overall increase in life expectancy and ageing demographics. As the population increases so will the demand for care.

The management of multimorbid patients entails various challenges. Firstly, healthcare systems are still largely focused on single diseases, and it is therefore not always easy to define the most appropriate care pathway for people with multiple conditions. Secondly, many multimorbid patients receive inappropriate interventions. They often face delays in their access to care, take multiple medicines on a daily basis, experience adverse drug reactions and, as a result, may fall out of treatment. This has a highly negative impact on the quality of life of both patients and their informal carers and it often leads to significant costs - an estimated 55% of all healthcare costs are due to multimorbidity, some of which are avoidable. It is therefore essential to optimise care pathways to ensure and improve the quality of care for individuals.

As it stands, the bulk of all long-term care in the EU is actually provided by informal carers. Informal carers are those who provide unpaid care outside of a professional context, typically this is relatives, friends, or neighbours. Women, in particular, provide the majority of care, as daughters (in law) and wives/partners.

However, many carers suffer from a lack of support and therefore face negative consequences as a result of their caregiving. For instance, mental health issues including depression and anxiety among informal carers is 20% higher than among non-carers. Carers are also less likely to meet their own health needs as their time is occupied assisting others.

Beyond impacts on health, many carers are faced with additional expenditures. Being cared for requires medication, special diets, home adaptations, etc. that carers are often responsible for providing. Working carers must often perform a difficult balancing act and may be forced to reduce their working hours or drop out of the labour market, thereby reducing their income and career growth. It is important to note that these adverse consequences faced by carers are exacerbated in high-intensity caregiving situations, such as providing care to multimorbid patients.

Research strongly indicates how supportive, effective and responsive partnerships between patients, informal carers and care professionals provides benefits enduring beyond the period of immediate contact. The involvement of informal carers in multimorbidity treatment may indeed help reduce the incidence of relapse and improve adherence to treatment, family functioning, and patients’ wellbeing and social adjustment. Lastly, the quality of life and confidence of informal carers greatly improves when their contribution is acknowledged and adequately supported.

Against this backdrop, it is very clear that supporting multimorbid patients and their informal carers is crucial to improving our care systems, with health and social benefits for all. This is the reason why ESCAPE’s holistic model of care that seeks to break down silos and realise win-win outcomes for all partners of the care pathway.