Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review
Introduction Multimorbidity, the coexistence of two or more chronic conditions in the same individual, is a major public health problem in low-income and middle-income countries (LMICs). The use of single-disease guidelines contributes to polypharmacy, fragmented care and increased treatment burden....
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/3/e074038.full |
| _version_ | 1797272335593504768 |
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| author | Tina George Gagandeep Kang Jo-Anne Manski-Nankervis Thambu David Sudarsanam Marlena Klaic |
| author_facet | Tina George Gagandeep Kang Jo-Anne Manski-Nankervis Thambu David Sudarsanam Marlena Klaic |
| author_sort | Tina George |
| collection | DOAJ |
| description | Introduction Multimorbidity, the coexistence of two or more chronic conditions in the same individual, is a major public health problem in low-income and middle-income countries (LMICs). The use of single-disease guidelines contributes to polypharmacy, fragmented care and increased treatment burden. Health systems in LMICs are very different from those in high-income countries, and adapting interventions from one to the other may not be feasible. This review aims to systematically present the current evidence for interventions for multimorbidity in the LMIC setting.Methods and analysis In this mixed-methods systematic review, we will include all studies of interventions for the care of adults (>18 years of age) with multimorbidity (defined as the presence of two or more chronic illnesses in an individual) in any healthcare organisation (primary, secondary or tertiary care) in an LMIC (as defined by the World Bank), published between 2000 and March 2023. All primary study designs will be included. Studies reported in languages other than English and those describing interventions classified as ‘financial’ or ‘governance arrangement’ according to the Cochrane Effective Practice and Organisation of Care classification will be excluded. MEDLINE, PubMed, Cochrane Library, TRIP, SCOPUS and the 3ie databases will be searched. The titles will be screened by one author, and two authors will independently screen all included abstracts and full texts. A third author will resolve conflicts at every stage. Studies will be reviewed for quality of evidence using appropriate tools. Epidemiological, intervention and outcome data will be extracted and summarised. Outcomes of interest for LMICs defined by the Global Alliance for Chronic Diseases research group will be analysed. Subgroup analysis according to study types and study settings will be done.Ethics and dissemination No ethics approval is required for this systematic review. Results will be disseminated through publication in an open-access journal and presentation at conferences.PROSPERO registration number CRD42023391897. |
| first_indexed | 2024-03-07T14:26:52Z |
| format | Article |
| id | doaj.art-24db2ce6b47b4d6e81c7de0d33a87028 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-07T14:26:52Z |
| publishDate | 2024-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-24db2ce6b47b4d6e81c7de0d33a870282024-03-06T05:45:11ZengBMJ Publishing GroupBMJ Open2044-60552024-03-0114310.1136/bmjopen-2023-074038Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic reviewTina George0Gagandeep Kang1Jo-Anne Manski-Nankervis2Thambu David Sudarsanam3Marlena Klaic4Department of Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, IndiaChristian Medical College Vellore, Vellore, IndiaDepartment of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of General Medicine, Christian Medical College and Hospital, Vellore, Tamilnadu, IndiaMelbourne School of Health Sciences, The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, AustraliaIntroduction Multimorbidity, the coexistence of two or more chronic conditions in the same individual, is a major public health problem in low-income and middle-income countries (LMICs). The use of single-disease guidelines contributes to polypharmacy, fragmented care and increased treatment burden. Health systems in LMICs are very different from those in high-income countries, and adapting interventions from one to the other may not be feasible. This review aims to systematically present the current evidence for interventions for multimorbidity in the LMIC setting.Methods and analysis In this mixed-methods systematic review, we will include all studies of interventions for the care of adults (>18 years of age) with multimorbidity (defined as the presence of two or more chronic illnesses in an individual) in any healthcare organisation (primary, secondary or tertiary care) in an LMIC (as defined by the World Bank), published between 2000 and March 2023. All primary study designs will be included. Studies reported in languages other than English and those describing interventions classified as ‘financial’ or ‘governance arrangement’ according to the Cochrane Effective Practice and Organisation of Care classification will be excluded. MEDLINE, PubMed, Cochrane Library, TRIP, SCOPUS and the 3ie databases will be searched. The titles will be screened by one author, and two authors will independently screen all included abstracts and full texts. A third author will resolve conflicts at every stage. Studies will be reviewed for quality of evidence using appropriate tools. Epidemiological, intervention and outcome data will be extracted and summarised. Outcomes of interest for LMICs defined by the Global Alliance for Chronic Diseases research group will be analysed. Subgroup analysis according to study types and study settings will be done.Ethics and dissemination No ethics approval is required for this systematic review. Results will be disseminated through publication in an open-access journal and presentation at conferences.PROSPERO registration number CRD42023391897.https://bmjopen.bmj.com/content/14/3/e074038.full |
| spellingShingle | Tina George Gagandeep Kang Jo-Anne Manski-Nankervis Thambu David Sudarsanam Marlena Klaic Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review BMJ Open |
| title | Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review |
| title_full | Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review |
| title_fullStr | Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review |
| title_full_unstemmed | Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review |
| title_short | Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review |
| title_sort | interventions in adult patients with multimorbidity in low income and middle income countries protocol for a mixed methods systematic review |
| url | https://bmjopen.bmj.com/content/14/3/e074038.full |
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