SynthesisBMJ open2019
Underlying mechanisms of complex interventions addressing the care of older adults with multimorbidity: a realist review.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 44 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Addressing Opioid Use Disorder in the Elderly Through Primary Care Innovation: Pain and Opioid Management in Older Adults
Protocol for a Cluster Randomised Trial of a Goal-Oriented Care Approach for Multimorbidity Patients Supported by a Digital Platform
Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Challenges and Perspectives in Treating Individuals With Musculoskeletal Disorders and Comorbidity: A Systematic Literature Review With a Descriptive Thematic Synthesis.Scandinavian journal of caring sciences · 2025Pooled it
- Identifying the active components through the behaviour change techniques taxonomy in complex interventions for people living with multiple long-term health conditions: A systematic review.British journal of health psychology · 2025Pooled it
- The health-related quality of life, mental health and mental illnesses of patients with inclusion body myositis (IBM): results of a mixed methods systematic review.Orphanet journal of rare diseases · 2022Pooled it
- Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Pooled it
- Challenges of Telemonitoring Programs for Complex Chronic Conditions: Randomized Controlled Trial With an Embedded Qualitative Study.Journal of medical Internet research · 2022Trial
- Assessment of an Interactive Digital Health-Based Self-management Program to Reduce Hospitalizations Among Patients With Multiple Chronic Diseases: A Randomized Clinical Trial.JAMA network open · 2021Trial
- Interpreting higher-order dependence in multimorbidity using cohort data: A partial information decomposition approach.PLoS computational biology · 2026Article
- Proactive health behaviour intervention strategies for older T2DM patients with multimorbidity: protocol for a cluster randomised controlled trial with hybrid type 2 effectiveness-implementation design.BMC primary care · 2026Article
- Changes in prehospital emergency medical services dispatch mission patterns and their public health implications during the COVID-19 pandemic in Beijing, China.International journal of emergency medicine · 2025Article
- Comparison of mortality and hospitalisation rates amongst older adults residing in professional foster families versus nursing homes: two parallel observational studies.Age and ageing · 2025Observational
- Quality of life in older immigrant adults on hemodialysis.PloS one · 2025Article
- Integrating general practitioners' and patients' perspectives in the development of a digital tool supporting primary care for older patients with multimorbidity: a focus group study.Frontiers in digital health · 2025Article
- Multimorbidity in elderly patients with or without T2DM: A real-world cross-sectional analysis based on primary care and hospitalisation data.Journal of global health · 2024Article
- Interventions Addressing Symptoms in Older Adults with Multimorbidity: An Umbrella Review.Journal of multidisciplinary healthcare · 2024Review
- Factors associated with self-management in older adults with multiple chronic conditions: a qualitative study.Frontiers in public health · 2024Article
- Protocol for a cluster randomised trial of a goal-oriented care approach for multimorbidity patients supported by a digital platform.BMJ open · 2023Article
- Article
- Changing dynamics of caregiving: a meta-ethnography study of informal caregivers' experiences with older immigrant family members in Europe.BMC health services research · 2023Review
- Patterns and Predictors of Multimorbidity in the Azar Cohort.Archives of Iranian medicine · 2023Article
- Healthcare for Older Adults with Multimorbidity: A Scoping Review of Reviews.Clinical interventions in aging · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
objectivesTo understand
designA realist review. DATA SOURCES: Electronic databases including Medline and Embase (inception to December 2017); and the grey literature. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We considered any studies (ie, experimental quasi-experimental, observational, qualitative and mixed-methods studies) as long as they provided data to explain our programme theories and effectiveness review (published elsewhere) findings. The population of interest was older adults (age ≥65 years) with two or more chronic conditions. ANALYSIS: We used the Realist And MEta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication criteria for our synthesis aimed at refining our programme theories such that they contained multiple context-mechanism-outcome configurations describing the ways different mechanisms fire to generate outcomes. We created a 3-step synthesis process grounded in meta-ethnography to separate units of data from articles, and to derive explanatory statements across them.
results106 articles contributed to the analysis. We refined our programme theories to explain multimorbidity management in older adults: (1) care coordination interventions with the best potential for impact are team-based strategies,
conclusionsTo optimise care, both clinical management and patient self-management need to be considered from multiple perspectives (patient, provider and system). To mitigate the complexities of multimorbidity management, patients focus on reducing symptoms and preserving quality of life while providers focus on the condition that most threaten morbidity and mortality. PROSPERO REGISTRATION NUMBER: CRD42014014489.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.