{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:24:52Z","timestamp":1787041492506,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multimorbidity\u2014coexistence of two or more chronic conditions in the same individual\u2014is a growing global healthcare challenge. Despite recognition of the difficulties in managing multimorbidity, there is a limited understanding of lived experiences and care improvement priorities as identified by key stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The study aimed to explore lived experiences of patients with multimorbidity, their family caregivers, and interprofessional healthcare workers, and to identify shared care improvement priorities. These findings were synthesized into a multimorbidity management toolkit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An experience\u2010based co\u2010design study with six stages was implemented, considering human\u2010centered design. Participants included patients aged 50\u2009years and above living with heart failure and multimorbidity, family caregivers, and multidisciplinary healthcare professionals recruited in Maryland, USA. Following study preparation and ethical approval (Stage 1), in\u2010depth individual interviews (Stages 2 and 3) were conducted, and the results were discussed during co\u2010design events and working group meetings (Stages 4 and 5) to reach a consensus on care priorities and specific strategies. The study findings were summarized into a multimorbidity management toolkit that was shared with participants at a celebration event (Stage 6). Data analysis included descriptive statistics and inductive thematic methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010six individual interviews were conducted: 24 patients (mean\u2009\u00b1\u2009SD age 71\u2009\u00b1\u20099\u2009years; 54% women; with an average of 8 morbidities), 7 family caregivers (mean\u2009\u00b1\u2009SD age 64\u2009\u00b1\u200914\u2009years; 57% women), and 15 healthcare professionals (mean\u2009\u00b1\u2009SD age 36\u2009\u00b1\u200910\u2009years). A total of 18 participants attended two co\u2010design events. Multiple working group meetings were organized to receive diverse input. Four shared care improvement priorities emerged: (1) communication, (2) care coordination and follow\u2010up care, (3) mental and emotional support, and (4) health education for patients and caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Person\u2010centered care models that emphasize shared strategies to improve communication, care coordination, education, and emotional support, as outlined in the toolkit, may enhance multimorbidity management and patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.70096","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T16:39:41Z","timestamp":1779899981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Shared Experiences and Care Improvement Priorities for Multimorbidity Management: An Experience\u2010Based Co\u2010Design Study"],"prefix":"10.1002","volume":"10","author":[{"given":"Binu","family":"Koirala","sequence":"first","affiliation":[{"name":"School of Nursing Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6465-0721","authenticated-orcid":false,"given":"Chitchanok","family":"Benjasirisan","sequence":"additional","affiliation":[{"name":"Medical Nursing Department, Faculty of Nursing Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arum","family":"Lim","sequence":"additional","affiliation":[{"name":"School of Nursing Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0264-7292","authenticated-orcid":false,"given":"Katie E.","family":"Nelson","sequence":"additional","affiliation":[{"name":"School of Nursing Johns Hopkins University  Baltimore Maryland USA"},{"name":"Department of International Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9683-324X","authenticated-orcid":false,"given":"Lyndsay","family":"DeGroot","sequence":"additional","affiliation":[{"name":"School of Nursing Johns Hopkins University  Baltimore Maryland USA"},{"name":"Indiana University School of Nursing  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Wright","sequence":"additional","affiliation":[{"name":"School of Nursing Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl R.","family":"Dennison Himmelfarb","sequence":"additional","affiliation":[{"name":"School of Nursing Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2050-1534","authenticated-orcid":false,"given":"Patricia M.","family":"Davidson","sequence":"additional","affiliation":[{"name":"University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00376-4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101860"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2196\/17026"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-022-02076-1"},{"key":"e_1_2_11_6_1","volume-title":"Living With Multiple Chronic Conditions: How We Achieve Holistic Care and Optimize Health Outcomes","author":"Koirala B.","year":"2022"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15998"},{"key":"e_1_2_11_8_1","volume-title":"Bringing User Experience to Healthcare Improvement: The Concepts, Methods and Practices of Experience\u2010Based Design","author":"Bate P.","year":"2007"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2752\/175630615X14212498964312"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzaa127"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09306-w"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2019109"},{"issue":"1","key":"e_1_2_11_13_1","article-title":"Interventions for Improving Outcomes in Patients With Multimorbidity in Primary Care and Community Settings","volume":"10","author":"Smith S. 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