RT Journal Article SR Electronic T1 Patient-centred innovation for multimorbidity care: a mixed-methods, randomised trial and qualitative study of the patients’ experience JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e320 OP e330 DO 10.3399/bjgp21X714293 VO 71 IS 705 A1 Moira Stewart A1 Martin Fortin A1 Judith Belle Brown A1 Bridget L Ryan A1 Pauline Pariser A1 Jocelyn Charles A1 Thuy-Nga Pham A1 Pauline Boeckxstaens A1 Sonja M Reichert A1 GY Zou A1 Onil Bhattacharya A1 Alan Katz A1 Helena Piccinini-Vallis A1 Tara Sampalli A1 Sabrina T Wong A1 Merrick Zwarenstein YR 2021 UL http://bjgp.org/content/71/705/e320.abstract AB Background Patient-centred interventions to help patients with multimorbidity have had mixed results.Aim To assess the effectiveness of a provider-created, patient-centred, multi-provider case conference with follow-up, and understand under what circumstances it worked, and did not work.Design and setting Mixed-methods design with a pragmatic randomised trial and qualitative study, involving nine urban primary care sites in Ontario, Canada.Method Patients aged 18–80 years with ≥3 chronic conditions were referred to the Telemedicine IMPACT Plus intervention; a nurse and patient planned a multi-provider case conference during which a care plan could be created. The patients were randomised into an intervention or control group. Two subgroup analyses and a fidelity assessment were conducted, with the primary outcomes at 4 months being self-management and self-efficacy. Secondary outcomes were mental and physical health status, quality of life, and health behaviours. A thematic analysis explored the patients’ experiences of the intervention.Results A total of 86 patients in the intervention group and 77 in the control group showed no differences, except that the intervention improved mental health status in the subgroup with an annual income of ≥C$50 000 (β-coefficient 11.003, P = 0.006). More providers and follow-up hours were associated with poorer outcomes. Five themes were identified in the qualitative study: valuing the team, patients feeling supported, receiving a follow-up plan, being offered new and helpful additions to their treatment regimen, and experiencing positive outcomes.Conclusion Overall, the intervention showed improvements only for patients who had an annual income of ≥C$50 000, implying a need to address the costs of intervention components not covered by existing health policies. Findings suggest a need to optimise team composition by revising the number and type of providers according to patient preferences and to enhance the hours of nurse follow-up to better support the patient in carrying out the case conference’s recommendations.