{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:24:53Z","timestamp":1776183893957,"version":"3.50.1"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Stiftung Gesundheitswissen","award":["LW03-20"],"award-info":[{"award-number":["LW03-20"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>It is particularly difficult for healthcare providers to deliver optimal medical care to multimorbid middle-aged persons because patients\u2019 professional activities, family lives, and other everyday responsibilities hinder them from making necessary lifestyle changes. Our aim was to find out how patients and healthcare providers view and manage the problems of dealing with multimorbidity in middle age.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods and findings<\/jats:title><jats:p>This qualitative study consisted of three steps. First, we conducted semi-structured in-depth interviews with 15 purposively sampled middle-aged persons living with multimorbidity to explore the experiences of care in the context of their leisure time, family lives, and work. Second, further individual interviews were carried out to find out the views of 14 healthcare providers. Third, the results of the interviews with patients and healthcare providers were presented to and discussed with four healthcare providers at an interprofessional workshop. Interview data was coded using an inductive-deductive approach and analyzed using content analysis. While patients reflected on challenges in several life domains, healthcare providers differentiated between levels of challenges. Both shared recommendations for better care including i) helping patients cope, ii) providing relief in activities of daily living, iii) continuity of care, iv) interprofessional cooperation, v) health promotion\/prevention, vi) expansion of health services and vii) general system-level changes. Furthermore, the healthcare provider workshop highlighted the importance of increasing patient-centeredness, reducing complexity through a care coordinator and promoting interprofessional cooperation\/networking.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Conclusions<\/jats:title><jats:p>To further improve the care of patients living with multimorbidity, barriers to managing multiple chronic conditions and facilitators to navigating complex care scenarios should be explored not only for people beyond working age, but for individuals in their mid-life specifically.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0291065","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T17:38:47Z","timestamp":1693503527000},"page":"e0291065","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["How do middle-aged patients and their healthcare providers manage multimorbidity? Results of a qualitative study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9774-6751","authenticated-orcid":true,"given":"Truc Sophia","family":"Dinh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9460-8313","authenticated-orcid":true,"given":"Robin","family":"Br\u00fcnn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria-Sophie","family":"Brueckle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirjam","family":"Dieckelmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana I.","family":"Gonz\u00e1lez Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjan","family":"van den Akker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"issue":"2","key":"pone.0291065.ref001","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3109\/13814789609162146","article-title":"Comorbidity or multimorbidity","volume":"2","author":"M van den Akker","year":"1996","journal-title":"European Journal of General Practice"},{"key":"pone.0291065.ref002","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s12875-015-0344-4","article-title":"Challenges of managing people with multimorbidity in today\u2019s healthcare systems","volume":"16","author":"K Moffat","year":"2015","journal-title":"BMC Fam Pract"},{"key":"pone.0291065.ref003","author":"World Health Organization","year":"2016","journal-title":"Multimorbidity: Technical Series of Safer Primary Care"},{"key":"pone.0291065.ref004","author":"J Lademann","year":"2005","journal-title":"Gesundheit von Frauen und M\u00e4nnern im mittleren Lebensalter: Schwerpunktbericht der Gesundheitsberichterstattung des Bundes"},{"issue":"3","key":"pone.0291065.ref005","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1177\/00914150211040451","article-title":"Multimorbidity and Multiple Role Demands Among Middle-Age Adults Based on the Canadian Longitudinal Study on Aging","volume":"94","author":"AV Wister","year":"2022","journal-title":"Int J Aging Hum Dev"},{"issue":"1","key":"pone.0291065.ref006","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1177\/0165025414533223","article-title":"Midlife as a Pivotal Period in the Life Course: Balancing Growth and Decline at the Crossroads of Youth and Old Age","volume":"39","author":"ME Lachman","year":"2015","journal-title":"International Journal of Behavioral Development"},{"key":"pone.0291065.ref007","first-page":"379","article-title":"Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study","author":"K Barnett","year":"2012","journal-title":"Lancet"},{"key":"pone.0291065.ref008","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.jclinepi.2012.05.005","article-title":"Cumulative complexity: a functional, patient-centered model of patient complexity can improve research and practice","volume":"62","author":"ND Shippee","year":"2012","journal-title":"Journal of clinical epidemiology"},{"issue":"1","key":"pone.0291065.ref009","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1186\/s12875-020-01262-2","article-title":"How does multimorbidity affect middle-aged adults? 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