Evidence map›Paper›PMID 38448058›Full record

ArticleBMJ open2024

Interventions in adult patients with multimorbidity in low-income and middle-income countries: protocol for a mixed-methods systematic review.

Tina George, Jo-Anne Manski-Nankervis, Marlena Klaic, Gagandeep Kang, Thambu David Sudarsanam

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Tina GeorgeDepartment of General Practice and Primary Care, The University of Melbourne,Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia george.t@unimelb.edu.au.ORCID 0000-0001-5978-7395
Jo-Anne Manski-NankervisDepartment of General Practice and Primary Care, The University of Melbourne,Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia.ORCID 0000-0003-2153-3482
Marlena KlaicMelbourne School of Health Sciences, The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia.ORCID 0000-0003-2328-0503
Gagandeep KangDivision of Gastrointestinal Sciences, Christian Medical College Vellore, Vellore, Tamil Nadu, India.ORCID 0000-0002-3656-564X
Thambu David SudarsanamDepartment of General Medicine, Christian Medical College Vellore, Vellore, India.ORCID 0000-0001-7283-7836

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMultimorbidity, the coexistence of two or more chronic conditions in the same individual, is a major public health problem in low-income and middle-income countries (LMICs). The use of single-disease guidelines contributes to polypharmacy, fragmented care and increased treatment burden. Health systems in LMICs are very different from those in high-income countries, and adapting interventions from one to the other may not be feasible. This review aims to systematically present the current evidence for interventions for multimorbidity in the LMIC setting. METHODS AND ANALYSIS: In this mixed-methods systematic review, we will include all studies of interventions for the care of adults (>18 years of age) with multimorbidity (defined as the presence of two or more chronic illnesses in an individual) in any healthcare organisation (primary, secondary or tertiary care) in an LMIC (as defined by the World Bank), published between 2000 and March 2023. All primary study designs will be included. Studies reported in languages other than English and those describing interventions classified as 'financial' or 'governance arrangement' according to the Cochrane Effective Practice and Organisation of Care classification will be excluded. MEDLINE, PubMed, Cochrane Library, TRIP, SCOPUS and the 3ie databases will be searched. The titles will be screened by one author, and two authors will independently screen all included abstracts and full texts. A third author will resolve conflicts at every stage. Studies will be reviewed for quality of evidence using appropriate tools. Epidemiological, intervention and outcome data will be extracted and summarised. Outcomes of interest for LMICs defined by the Global Alliance for Chronic Diseases research group will be analysed. Subgroup analysis according to study types and study settings will be done. ETHICS AND DISSEMINATION: No ethics approval is required for this systematic review. Results will be disseminated through publication in an open-access journal and presentation at conferences. PROSPERO REGISTRATION NUMBER: CRD42023391897.

Indexed as

Group PracticeMultimorbidityAdultDatabases, FactualDeveloping CountriesHumansResearch DesignSystematic Reviews as TopicAgingChronic DiseaseHealth ServicesSystematic Review

Identifiers

PMID38448058
PMCPMC10916128

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Registered trials

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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.