Article Text

Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: protocol for a systematic review alongside a realist review
  1. Monika Kastner1,2,
  2. Laure Perrier1,
  3. Jemila Hamid1,3,
  4. Andrea C Tricco1,2,
  5. Roberta Cardoso1,
  6. Noah M Ivers4,
  7. Barbara Liu5,
  8. Sharon Marr6,
  9. Jayna Holroyd-Leduc7,
  10. Geoff Wong8,
  11. Lisa Graves9,
  12. Sharon E Straus1,10
  1. 1Li KaShing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
  2. 2Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  3. 3Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
  4. 4Department of Family Medicine, Women's College Hospital—University of Toronto, Toronto, Ontario, Canada
  5. 5Regional Geriatric Program of Toronto; Sunnybrook Health Sciences, Geriatric Medicine, Toronto, Ontario, Canada
  6. 6Division of Geriatric Medicine McMaster University, St Peter's Hospital/Hamilton Health Sciences, Hamilton, Ontario, Canada
  7. 7Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  8. 8Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK
  9. 9Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada
  10. 10Department of Medicine, University of Toronto, St Michael's Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Monika Kastner; monika.kastner{at}


Introduction The burden of chronic disease is a global phenomenon, particularly among people aged 65 years and older. More than half of older adults have more than one chronic disease and their care is not optimal. Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions.

Methods and analysis We will conduct a systematic review alongside a realist review to identify effective CDM tools that integrate one or more high-burden chronic diseases affecting older adults and to better understand for whom, under what circumstances, how and why they produce their outcomes. We will search MEDLINE, EMBASE, CINAHL, AgeLine and the Cochrane Library for experimental, quasi-experimental, observational and qualitative studies in any language investigating CDM tools that facilitate optimal disease management in one or more high-burden chronic diseases affecting adults aged ≥65 years. Study selection will involve calibration of reviewers to ensure reliability of screening and duplicate assessment of articles. Data abstraction and risk of bias assessment will also be performed independently. Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (meta-analysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies.

Ethics and dissemination Ethics approval is not required for this study. We anticipate that our findings, pertaining to gaps in care across high-burden chronic diseases affecting seniors and highlighting specific areas that may require more research, will be of interest to a wide range of knowledge users and stakeholders. We will publish and present our findings widely, and also plan more active dissemination strategies such as workshops with our key stakeholders.

Trial registration number Our protocol is registered with PROSPERO (registration number CRD42014014489).

  • GENERAL MEDICINE (see Internal Medicine)

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