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Mixed evidence on interventions for improving outcomes in patients with multimorbidity
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Mixed evidence on interventions for improving outcomes in patients with multimorbidity
How effective are health-service or patient-oriented interventions designed to improve outcomes in patients with multimorbidity, in primary care and community settings?
Overall, the results regarding the effectiveness of interventions were mixed. There were no clear positive improvements in clinical outcomes, health service use, medication adherence, patient-related health behaviours, health professional behaviours or costs. There were modest improvements in mental health outcomes from 7 studies that targeted people with depression and in functional outcomes from 2 studies targeting functional difficulties in participants. Overall, the results indicate it is difficult to improve outcomes for people with multiple conditions. The review suggests interventions that are designed to target specific risk factors (for example, treatment for depression) or interventions that focus on difficulties people experience with daily functioning (for example, physiotherapy treatment to improve capacity for physical activity) may be more effective.
The overall quality of these studies was good, although many studies did not fully report on all potential sources of bias. As definitions of multimorbidity varied among studies, the potential to reasonably combine study results and draw overall conclusions was limited.
Many people with a chronic health problem or condition have more than one condition, referred to as multimorbidity. Little is known about the effectiveness of interventions to improve outcomes for people with multimorbidity.
Smith SM et al. Interventions for improving outcomes in patients with multimorbidity in primary care and community settings. Cochrane Reviews, 2016, Issue 3. Art. No.: CD006560.DOI: 10.1002/14651858. CD006560.pub2. This review contains 18 studies involving 8,727 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz