Critical review of multimorbidity outcome measures suitable for low-income and middle-income country settings: perspectives from the Global Alliance for Chronic Diseases (GACD) researchers. Issue 9 (6th September 2020)

• Record Type: Journal Article
• Authors: Hurst, John R; Agarwal, Gina; van Boven, Job F M; Daivadanam, Meena; Gould, Gillian Sandra; Wan-Chun Huang, Erick; Maulik, Pallab K; Miranda, J Jaime; Owolabi, M O; Premji, Shahirose Sadrudin; Soriano, Joan B; Vedanthan, Rajesh; Yan, Lijing; Levitt, Naomi
• Other Names: author non-byline.; Araya Ricardo author non-byline.; Bobrow Kirsten author non-byline.; Chavannes Niels H author non-byline.; Xavier Gómez-Olivé F author non-byline.; Jaffar Shabbar author non-byline.; Kirenga Bruce J author non-byline.; Kleij Rianne M J J van der author non-byline.; Kulkarni Muralidhar M author non-byline.; Loli-Dano Laura author non-byline.; Lopez-Jaramillo Patricio author non-byline.; Norris Shane author non-byline.; Olmen Josefien van author non-byline.; Parker Gary author non-byline.; Siddharthan Trishul author non-byline.; Siddiqi Kamran author non-byline.; Siddiqi Najma author non-byline.; Trofor Antigona C author non-byline.
• Is Part Of: BMJ open. Volume 10:Issue 9(2020)
• Publication Date: 2020-09-06
• Subjects: primary care -- public health -- statistics & research methods -- clinical trials; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-037079
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: There is growing recognition around the importance of multimorbidity in low-income and middle-income country (LMIC) settings, and specifically the need for pragmatic intervention studies to reduce the risk of developing multimorbidity, and of mitigating the complications and progression of multimorbidity in LMICs. One of many challenges in completing such research has been the selection of appropriate outcomes measures. A 2018 Delphi exercise to develop a core-outcome set for multimorbidity research did not specifically address the challenges of multimorbidity in LMICs where the global burden is greatest, patterns of disease often differ and health systems are frequently fragmented. We, therefore, aimed to summarise and critically review outcome measures suitable for studies investigating mitigation of multimorbidity in LMIC settings. Setting: LMIC. Participants: People with multimorbidity. Outcome measures: Identification of all outcome measures. Results: We present a critical review of outcome measures across eight domains: mortality, quality of life, function, health economics, healthcare access and utilisation, treatment burden, measures of 'Healthy Living' and self-efficacy and social functioning. Conclusions: Studies in multimorbidity are necessarily diverse and thus different outcome measures will be appropriate for different study designs. Presenting the diversity of outcome measures across domains should provide a useful summary for researchers, encourage the use of multiple domains in multimorbidity research, and provoke debate and progress in the field.