Aims
Multimorbidity in people with cancer (the presence of least one other chronic condition in addition to cancer) is common. The aim of this study was to identify priorities for care delivery and research for cancer survivors with multimorbidity in the Australian setting.
Methods
A Delphi consensus process was conducted with Australian health professionals, cancer survivors with lived experience of multimorbidity, and researchers. Elements of multimorbidity care and research were identified from Australia’s National Strategic Framework for Chronic Conditions, a literature review, and expert input. In Round 1, participants were asked to rate the importance of the elements (18 principles, 9 enablers, and 4 objectives) as they related to i) care delivery and ii) research. In Round 2, new elements were rated, and all elements were ranked in terms of importance.
Results
In Round 1, all elements reached consensus for care delivery, however three principles and one enabler did not reach consensus for research and were not included in Round 2. Based on participant suggestions, one new principle and two new enablers were added, which all reached consensus in Round 2. At the end of the Delphi process, a total of 19 principles, 10 enablers, and 4 objectives reached consensus and were included under care delivery. Fourteen principles, 9 enablers, and 4 objectives reached consensus and were included under research. The principles of ‘survivorship’ and ‘self-management’ were ranked highest under care delivery, and ‘peer support’ and ‘technology’ were ranked as the most important enablers. For research, ‘survivorship’ and ‘coordinated care’ were the most important principles, and ‘peer support’ and ‘education’ were the most important enablers.
Conclusions
While many elements of chronic disease management apply to both the general population and cancer survivors, some elements are unique to people with cancer and warrant consideration when managing multimorbidity in this population.