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The Ariadne principles: how to handle multimorbidity in primary care consultations

Overview of attention for article published in BMC Medicine, December 2014
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • Good Attention Score compared to outputs of the same age and source (78th percentile)

Mentioned by

2 policy sources
45 tweeters
1 Facebook page
1 Google+ user


146 Dimensions

Readers on

238 Mendeley
2 CiteULike
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The Ariadne principles: how to handle multimorbidity in primary care consultations
Published in
BMC Medicine, December 2014
DOI 10.1186/s12916-014-0223-1
Pubmed ID

Christiane Muth, Marjan van den Akker, Jeanet W Blom, Christian D Mallen, Justine Rochon, François G Schellevis, Annette Becker, Martin Beyer, Jochen Gensichen, Hanna Kirchner, Rafael Perera, Alexandra Prados-Torres, Martin Scherer, Ulrich Thiem, Hendrik van den Bussche, Paul P Glasziou


Multimorbidity is a health issue mostly dealt with in primary care practice. As a result of their generalist and patient-centered approach, long-lasting relationships with patients, and responsibility for continuity and coordination of care, family physicians are particularly well placed to manage patients with multimorbidity. However, conflicts arising from the application of multiple disease oriented guidelines and the burden of diseases and treatments often make consultations challenging. To provide orientation in decision making in multimorbidity during primary care consultations, we developed guiding principles and named them after the Greek mythological figure Ariadne. For this purpose, we convened a two-day expert workshop accompanied by an international symposium in October 2012 in Frankfurt, Germany. Against the background of the current state of knowledge presented and discussed at the symposium, 19 experts from North America, Europe, and Australia identified the key issues of concern in the management of multimorbidity in primary care in panel and small group sessions and agreed upon making use of formal and informal consensus methods. The proposed preliminary principles were refined during a multistage feedback process and discussed using a case example. The sharing of realistic treatment goals by physicians and patients is at the core of the Ariadne principles. These result from i) a thorough interaction assessment of the patient's conditions, treatments, constitution, and context; ii) the prioritization of health problems that take into account the patient's preferences - his or her most and least desired outcomes; and iii) individualized management realizes the best options of care in diagnostics, treatment, and prevention to achieve the goals. Goal attainment is followed-up in accordance with a re-assessment in planned visits. The occurrence of new or changed conditions, such as an increase in severity, or a changed context may trigger the (re-)start of the process. Further work is needed on the implementation of the formulated principles, but they were recognized and appreciated as important by family physicians and primary care researchers.Please see related article: http://www.biomedcentral.com/1741-7015/12/222.

Twitter Demographics

The data shown below were collected from the profiles of 45 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 238 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 2 <1%
United Kingdom 1 <1%
Brazil 1 <1%
France 1 <1%
Denmark 1 <1%
Netherlands 1 <1%
United States 1 <1%
Unknown 230 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 43 18%
Student > Ph. D. Student 34 14%
Student > Master 34 14%
Student > Bachelor 17 7%
Other 16 7%
Other 61 26%
Unknown 33 14%
Readers by discipline Count As %
Medicine and Dentistry 116 49%
Nursing and Health Professions 18 8%
Social Sciences 18 8%
Pharmacology, Toxicology and Pharmaceutical Science 8 3%
Biochemistry, Genetics and Molecular Biology 5 2%
Other 23 10%
Unknown 50 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 33. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 February 2018.
All research outputs
of 17,780,770 outputs
Outputs from BMC Medicine
of 2,739 outputs
Outputs of similar age
of 316,130 outputs
Outputs of similar age from BMC Medicine
of 247 outputs
Altmetric has tracked 17,780,770 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,739 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 39.2. This one has done well, scoring higher than 78% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 316,130 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 247 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 78% of its contemporaries.