Article Text
Abstract
Objectives There is growing recognition around the importance of multimorbidity in low-income and middle-income country (LMIC) settings, and specifically the need for pragmatic intervention studies to reduce the risk of developing multimorbidity, and of mitigating the complications and progression of multimorbidity in LMICs. One of many challenges in completing such research has been the selection of appropriate outcomes measures. A 2018 Delphi exercise to develop a core-outcome set for multimorbidity research did not specifically address the challenges of multimorbidity in LMICs where the global burden is greatest, patterns of disease often differ and health systems are frequently fragmented. We, therefore, aimed to summarise and critically review outcome measures suitable for studies investigating mitigation of multimorbidity in LMIC settings.
Setting LMIC.
Participants People with multimorbidity.
Outcome measures Identification of all outcome measures.
Results We present a critical review of outcome measures across eight domains: mortality, quality of life, function, health economics, healthcare access and utilisation, treatment burden, measures of ‘Healthy Living’ and self-efficacy and social functioning.
Conclusions Studies in multimorbidity are necessarily diverse and thus different outcome measures will be appropriate for different study designs. Presenting the diversity of outcome measures across domains should provide a useful summary for researchers, encourage the use of multiple domains in multimorbidity research, and provoke debate and progress in the field.
- primary care
- public health
- statistics & research methods
- clinical trials
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Footnotes
Twitter @GillianSGould
Correction notice This article has been corrected since it was published. The licence has been updated.
Collaborators GACD Multimorbidity Working Group: Ricardo Araya, Kirsten Bobrow, Niels H Chavannes, F Xavier Gómez-Olivé, Shabbar Jaffar, Bruce J Kirenga, Rianne M J J van der Kleij, Muralidhar M Kulkarni, Laura Loli-Dano, Patricio Lopez-Jaramillo, Shane Norris, Josefien van Olmen, Gary Parker, Trishul Siddharthan, Kamran Siddiqi, Najma Siddiqi, Antigona C Trofor.
Contributors The concept for this paper arose from discussion at the GACD Multimorbidity Working Group chaired by JRH. The authors (JRH, GA, JFMvB, MD, GSG, EW-CH, PKM, JJM, MOO, SP, JS, RV, LY and NL) planned and conducted the e-mail survey. All authors and contributors (RA, KB, NHC, FXG-O, SJ, BJK, RMJJvdK, MMK, LL-D, PL-J, SN, JvO, GP, TS, KS, NS and ACT) provided suggestions for outcome measures. Individual sections of the manuscript were drafted by the authors, coordinated by JRH into a first complete draft. All authors revised this initial draft. All authors and contributors provided important intellectual content on the revised draft and approved the final version for submission.
Funding The article was supported by the Global Alliance for Chronic Diseases (GACD) secretariat. The Authors are investigators on individual studies funded in collaboration with the GACD.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study.