Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 12, 2024
Date Accepted: Jul 9, 2024
The Effectiveness of Collaborative Care Interventions for the Management of Patients with Multimorbidity: Protocol for a Systematic Review, Meta-Analysis, and Meta-Regression Analysis
ABSTRACT
Background:
Collaborative care interventions have been proposed as a promising strategy to support patients with multimorbidity. Despite this, the effectiveness of collaborative care interventions requires further evaluation. Existing systematic reviews describing the effectiveness of collaborative care interventions in multimorbidity management tend to focus on specific interventions, patient subgroups, and settings. This necessitates a comprehensive review, that will provide an overview of the effectiveness of collaborative care interventions for adult patients with multimorbidity.
Objective:
This systematic review aims to systematically assess the effectiveness of collaborative care interventions in comparison to usual care concerning patient reported outcomes (PROs) and mortality among adult patients with multimorbidity.
Methods:
Randomized controlled trials evaluating collaborative care interventions designed for adult patients (aged 18 years or older) with multimorbidity compared with usual care will be considered for inclusion in this review. Health-related quality of life will be the primary outcome. Mortality and mental outcomes, such as rating scales for anxiety and depression, will serve as secondary outcomes. The systematic search will be conducted in CENTRAL (Cochrane Central Register of Controlled Trials), PubMed, CINAHL, and Embase. Additional reference and citation search will be performed in Google Scholar, Web of Science and Scopus. Data extraction will be comprehensive and include information about participants characteristics, study design, intervention details,and main outcomes. Included studies will be assessed for limitations according to the Cochrane Risk of Bias Tool. Meta-analysis will be conducted to estimate pooled effect size. Meta-regression or subgroup analysis will be undertaken to explore if certain factors can explain the variation in effect between studies, if feasible. The certainty of evidence will be evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.
Results:
The anticipated result of this review is an overview of pooled estimates of treatment effects across various PROs and mortality employed in randomized controlled trails evaluating collaborative care interventions for adults with multimorbidity. Furthermore, the intention is to clarify the participant, intervention, or study characteristics that may influence the effect of the interventions.
Conclusions:
This review is expected to provide valuable insights for researchers, clinicians, and other decision-makers about the effectiveness of collaborative care interventions targeted adult patients with multimorbidity Clinical Trial: International Prospective Register of Systematic Reviews (PROSPERO) CRF42024512554; https//www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=512554
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