This document discusses developing an item set from the International Classification of Functioning (ICF) to understand patient functioning for multimorbid patients in general practice. It notes that while diagnoses show medical issues, they do not capture patient functioning. The researchers conducted a study with GPs to identify which ICF items are most relevant to register for multimorbid patients and the willingness of GPs to record this information. The study found some but not full agreement among GPs on useful functioning items, and concluded that the ICF-based approach is viable and could be applied in other GP studies.

1. WHO-FIC Network| FDRG Poster
Barcelona, 10-17 Oktober 2014
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A desired ICF item set for multimorbid
patients in General Practice
Dutch WHO-FIC
Collaborating Centre
Bob Emmen(a)
Kees van Boven(a)
Huib Ten Napel(b)(a)
(a) Department of Primary and
Community Care, Radboud
university medical centre,
Nijmegen
(b) WHO-FIC Collaborating
Centre, RIVM Bilthoven,
Netherlands
FDRG poster session

2.  In (Dutch) General Practice there is a general ‘intuition’ that
‘something’ is missing, when only medical information is registered.
 A diagnosis reveals little about one’s functioning. Diagnoses are
important for defining the cause and prognosis, but identifying
problems in functioning is often the key information that is being used
to plan and implement interventions in General Practice.
 The perception is that a ‘health-functioning’ oriented approach might
help GP’s to understand patients’ reactions to complaints and the
treatment they receive.
 However, using the complete content of ICF is not feasible for
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Dutch WHO-FIC
Collaborating Centre
everyday use.
Introduction and rationale

3. Introduction and rationale
 What do General Practitioners (GPs) want to know about a patient in
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Dutch WHO-FIC
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terms of functioning?
 There is no existing literature describing or exploring the desired
content of such an item-set or core set, to be used in General
Practice.
 A number of studies will be undertaken to assess the usability of ICF
for General Practice.
 The first of these studies is focused on which ICF items are
considered relevant by GPs’ to be registered in multimorbid patients,
including the willingness to register them.

4. WHO-FIC Network| FDRG Poster
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Method used
 2 sources: National GP guidelines
& ICF brief core sets; relevant
items selected through rules
 Translated into ICF items by 2
raters (consensus procedure)
 Translated back into everyday
questions apt for use in GP
practice (WHODAS / EASYCARE)
 56 participating GPs received ICF
video instruction and ½- qualitative
explorative online survey
(ALWAYS/ NEVER/ SOMETIMES)

5. Items always to have registered
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(5 out of 10)

6. Items never to have registered
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(5 out of 10)

7. Usefulness of functioning items
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8. Conclusion and acknowledgement
 Conclusion I: No 100% concordance, still useful, low response
 Conclusion II: Approach is viable, could be used in other GP studies
 We would like to express gratitude to all participating GPs’.
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Barcelona, 10-17 Oktober 2014
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Dutch WHO-FIC
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 For more information:
-Newsletter on the WHO-FIC, Vol 12, 2014 - 1
-Poster # 522
-Full thesis: http://www.icfinternational.info/wp-content/
uploads/2014/02/report_bobemmen_ICF.pdf
-Youtube: http://youtu.be/9FkcHwaO0iY

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Dutch WHO-FIC
Collaborating Centre