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Thirteen articles met study inclusion criteria. Patients reported nine categories of barriers including financial constraints, logistical challenges, physical limitations, lifestyle changes, emotional impact, inadequate family and social support, and the complexity of managing multiple conditions, medications, and communicating with health care providers. Four facilitators were found, including health system support, individualized care education and knowledge, informal support from family and social systems, and having personal mental and emotional strength. Existing research on management of MCC from the patient\u2019s perspective is limited. Interventions are needed to improve management practices with particular attention to the knowledge and skills required by this unique population.<\/jats:p>","DOI":"10.1177\/0193945914549058","type":"journal-article","created":{"date-parts":[[2014,9,6]],"date-time":"2014-09-06T02:35:55Z","timestamp":1409970955000},"page":"498-516","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":76,"title":["Barriers and Facilitators to Managing Multiple Chronic Conditions"],"prefix":"10.1177","volume":"37","author":[{"given":"Gina","family":"Koch","sequence":"first","affiliation":[{"name":"University of Missouri Sinclair School of Nursing, Columbia, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie J.","family":"Wakefield","sequence":"additional","affiliation":[{"name":"University of Missouri Sinclair School of Nursing, Columbia, MO, USA"},{"name":"Iowa City Veterans Affairs Healthcare System Center for Comprehensive Access and Delivery Research & Evaluation (CADRE), Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Wakefield","sequence":"additional","affiliation":[{"name":"University of Missouri Center for Health Care Quality, Columbia, MO, USA"},{"name":"University of Missouri Department of Health Management & Informatics, Columbia, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,9,5]]},"reference":[{"key":"bibr1-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmn040"},{"key":"bibr2-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2008.05.002"},{"key":"bibr3-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1370\/afm.4"},{"key":"bibr4-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1177\/0145721713486837"},{"key":"bibr5-0193945914549058","volume-title":"Care management of patients with complex health care needs","author":"Bodenheimer T.","year":"2009"},{"key":"bibr6-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1097\/NCM.0b013e3181f508d0"},{"key":"bibr7-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmp106"},{"key":"bibr8-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.21.4.222"},{"key":"bibr9-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2005.09.002"},{"key":"bibr10-0193945914549058","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.14093"},{"key":"bibr11-0193945914549058","first-page":"1694","volume":"173","author":"Hochman M. 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