Multimorbilidad en atención primaria: Coordinación del cuidado, carga del cuidador y priorización clínica
DOI:
https://doi.org/10.66476/mf.v3n1.7162Keywords:
multimorbilidad, atención primaria, medicina familiar, carga del cuidador, priorización clínica, toma de decisiones compartidaAbstract
Antecedentes: La multimorbilidad es frecuente en atención primaria y exige decisiones centradas en la persona, coordinación entre servicios y apoyo a cuidadores. Los modelos orientados a una sola enfermedad suelen responder mal cuando se acumulan síntomas, tratamientos y demandas familiares.
Métodos: Se realizó una revisión narrativa en español con búsqueda estructurada entre enero de 2020 y julio de 2026. Se priorizaron revisiones narrativas, de alcance e integrativas, revisiones sistemáticas de alta relevancia y marcos conceptuales sobre coordinación del cuidado, carga del tratamiento, carga del cuidador y priorización compartida, complementados con estudios empíricos recientes.
Resultados: El corpus final incluyó 21 fuentes, principalmente de Norteamérica y Europa, con aportes adicionales de Asia y África. La evidencia converge en que la multimorbilidad requiere continuidad relacional, coordinación visible y metas realistas. Los modelos centrados en la persona funcionan mejor cuando reducen fragmentación y hacen más manejable la toma de decisiones. La carga del cuidador emerge como parte del problema clínico, porque el apoyo informal sostiene la adherencia, la organización cotidiana y la viabilidad del plan terapéutico. La priorización clínica ayuda a ordenar qué hacer primero, qué posponer y qué dejar de hacer según lo que la persona valora.
Conclusión: En medicina familiar y comunitaria, la multimorbilidad debe abordarse por trayectorias, prioridades y contexto familiar, no solo por diagnósticos. El objetivo práctico es sostener un plan clínicamente razonable y humanamente viable para pacientes y cuidadores.
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Copyright (c) 2026 Adria Maria Carvalho de Sousa, Yago Dos Santos Theophilo, Alini Santos Bianchi, Rhaissa Assunção da Silva, Vitória Jacob de Farias
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