Discussion
Diabetes, multimorbidity, MCC, diabetes
DIABETES, TYPE 2 DIABETES, MCC, DIABETES
Key findings of this study were that the ACHRU-CPP increased in-depth dialogue with ‘Older adults with multimorbidity and diabetes face significant burden in managing their chronic conditions, which challenge their self-care and adversely affect their overall quality of life.A novel finding of this study was that the ACHRU-CPP was perceived by older adults from three Canadian provinces to positively impact their self-management practices of diabetes and MCC by helping to address their broad health and social needs. This has not been documented before in similar studies.When healthcare providers recommend lifestyle changes, they need to recognise that social determinants of health such as housing, food security, social relationships and financial stability have an impact on older adults’ abilities to enact them.In the current study, older adults appreciated receiving person-centred care supported by a team of providers from primary care and community sectors and the engagement of providers outside of the intervention team (such as social workers). Due to the complex nature of diabetes and MCC, interprofessional collaboration has been found to lead to positive outcomes for persons with type 2 diabetes, such as improvements in HbA1c levels, regular testing of blood glucose levels and smoking cessation.What is unique about this study is the partnership between healthcare providers and a programme coordinator from a local community partner site. These health and social services can be underused if healthcare providers are not aware of them. As per the Quintuple Aim,Person-centred care was perceived to be key strength of the ACHRU-CPP that enabled older adults to improve self-management practices related to diabetes and MCC. In working towards a person-centred learning health system, defined as a health system that integrates internal data, patient experience and research evidence,In practice and policy, there is a need for integrated care delivery models that leverage community partnerships to help fill gaps in meeting the complex health and social needs of older adults with diabetes. To advance Quintuple Aim outcomes,The strengths of the study include its rigorous qualitative design and large sample size, and the inclusion of diverse participants with regard to sex, marital status and annual income, from multiple sites across Canada. A limitation of the study was related to the sample as there was a lack of cultural diversity and under-representation of older adults from marginalised communities. A Diabetes Canada roundtable of key stakeholders recently emphasised the need to implement community-based interventions,