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Health-related preferences of older patients with multimorbidity: the protocol for an evidence map
  1. Ana Isabel González-González GONZALEZ1,2,
  2. Christine Schmucker3,
  3. Jeanet Blom4,
  4. Marjan van den Akker1,
  5. Truc Sophia Nguyen1,
  6. Julia Nothacker3,
  7. Joerg J Meerpohl3,
  8. Kristian Röttger5,
  9. Odette Wegwarth6,
  10. Tammy Hoffmann7,
  11. Sharon E Straus8,
  12. Ferdinand M Gerlach1,
  13. Christiane Muth1
  1. 1 Institute of General Practice, Johann Wolfgang Goethe University, Frankfurt, Germany
  2. 2 Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
  3. 3 Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
  4. 4 Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
  5. 5 Patient Representative, Federal Joint Committee “Gemeinsamer Bundesausschuss”, Berlin, Germany
  6. 6 Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
  7. 7 Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
  8. 8 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Ana Isabel González-González; gonzalezgonzalez{at}


Introduction Interaction of conditions and treatments, complicated care needs and substantial treatment burden make patient–physician encounters involving multimorbid older patients highly complex. To optimally integrate patients’ preferences, define and prioritise realistic treatment goals and individualise care, a patient-centred approach is recommended. However, the preferences of older patients, who are especially vulnerable and frequently multimorbid, have not been systematically investigated with regard to their health status. The purpose of this evidence map is to explore current research addressing health-related preferences of older patients with multimorbidity, and to identify the knowledge clusters and research gaps.

Methods and analysis To identify relevant research, we will conduct searches in the electronic databases MEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL, Social Science Citation Index, Social Science Citation Index Expanded and the Cochrane library from their inception. We will check reference lists of relevant articles and carry out cited reference research (forward citation tracking). Two independent reviewers will screen titles and abstracts, check full texts for eligibility and extract the data. Any disagreement will be resolved and consensus reached with the help of a third reviewer. We will include both qualitative and quantitative studies, and address preferences from the patients’ perspectives in a multimorbid population of 60 years or older. There will be no restrictions on the publication language. Data extraction tables will present study and patient characteristics, aim of study, methods used to identify preferences and outcomes (ie, type of preferences). We will summarise the data using tables and figures (ie, bubble plot) to present the research landscape and to describe clusters and gaps.

Ethics and dissemination Due to the nature of the proposed evidence map, ethics approval will not be required. Results from our research will be disseminated by means of specifically prepared materials for patients, at relevant (inter)national conferences and via publication in peer-reviewed journals.

  • multimorbidity
  • patient preference
  • aged

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  • Contributors AIG wrote the initial draft of the protocol. CM is the guarantor of the review. CS and JJM provided methodological guidance and revisions of the manuscript. CS and JN assisted in the identification of databases and reviewed the search strategy. JB, MvdA, TSN, JN, OW, KR, TH, FMG and SES are cosupervisors of this project, provided advice at all stages of the development of the protocol, and contributed to the revision of the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by the German Federal Ministry of Education and Research, grant number 01GL1729.

  • Disclaimer The funder had no role in developing the protocol for this review.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Due to the nature of the proposed evidence map, ethics approval will not be required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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