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
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 o...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e037079.full |
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| author | Najma Siddiqi Meena Daivadanam J Jaime Miranda Trishul Siddharthan John R Hurst Rajesh Vedanthan Gary Parker Gina Agarwal Shabbar Jaffar Naomi Levitt Niels H Chavannes Pallab K Maulik Patricio Lopez-Jaramillo Kamran Siddiqi Muralidhar M Kulkarni Gillian Sandra Gould Job F M van Boven Kirsten Bobrow M O Owolabi Joan B Soriano Erick Wan-Chun Huang Shahirose Sadrudin Premji Lijing Yan Ricardo Araya F Xavier Gómez-Olivé Bruce J Kirenga Rianne M J J van der Kleij Laura Loli-Dano Shane Norris Josefien van Olmen Antigona C Trofor |
| author_facet | Najma Siddiqi Meena Daivadanam J Jaime Miranda Trishul Siddharthan John R Hurst Rajesh Vedanthan Gary Parker Gina Agarwal Shabbar Jaffar Naomi Levitt Niels H Chavannes Pallab K Maulik Patricio Lopez-Jaramillo Kamran Siddiqi Muralidhar M Kulkarni Gillian Sandra Gould Job F M van Boven Kirsten Bobrow M O Owolabi Joan B Soriano Erick Wan-Chun Huang Shahirose Sadrudin Premji Lijing Yan Ricardo Araya F Xavier Gómez-Olivé Bruce J Kirenga Rianne M J J van der Kleij Laura Loli-Dano Shane Norris Josefien van Olmen Antigona C Trofor |
| author_sort | Najma Siddiqi |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-9bd74b9a43a94b329e9414e0fb9bf5e0 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-9bd74b9a43a94b329e9414e0fb9bf5e02025-01-09T00:00:11ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-037079Critical review of multimorbidity outcome measures suitable for low-income and middle-income country settings: perspectives from the Global Alliance for Chronic Diseases (GACD) researchersNajma Siddiqi0Meena Daivadanam1J Jaime Miranda2Trishul Siddharthan3John R Hurst4Rajesh Vedanthan5Gary ParkerGina Agarwal6Shabbar Jaffar7Naomi Levitt8Niels H Chavannes9Pallab K Maulik10Patricio Lopez-Jaramillo11Kamran Siddiqi12Muralidhar M Kulkarni13Gillian Sandra Gould14Job F M van Boven15Kirsten Bobrow16M O Owolabi17Joan B Soriano18Erick Wan-Chun Huang19Shahirose Sadrudin Premji20Lijing Yan21Ricardo Araya22F Xavier Gómez-OlivéBruce J KirengaRianne M J J van der KleijLaura Loli-DanoShane NorrisJosefien van OlmenAntigona C Trofor1 University of York, York, UKGlobal Health and Migration Unit, Department of Women`s and Children`s Health, Uppsala University, Uppsala, Sweden8 CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruDivision of Pulmonary, Critical care and Sleep medicine, University of Miami School of Medicine, Miami, Florida, USAUCL Respiratory, University College London, London, UKPopulation Health, New York University Grossman School of Medicine, New York, New York, USADepartment of Family Medicine, McMaster University, Hamilton, Ontario, CanadaInstitute for Global Health, University College London, London, UK6 Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, Western Cape, South AfricaDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The NetherlandsResearch, The George Institute for Global Health, New Delhi, IndiaMasira Research Institute, Universidad de Santander, Bucaramanga, Colombia1 University of York, York, UKCommunity Medicine, Kasturba Medical College, Manipal Acadamy of Higher Education, Manipal, Karnataka, IndiaFaculty of Health, Southern Cross University, Lismore, New South Wales, AustraliaDepartment of Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, Groningen, The NetherlandsDivision of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South AfricaMedicine, University of Ibadan College of Medicine, Ibadan, NigeriaUniversidad Autónoma de Madrid, Madrid, SpainRespiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, Sydney, New South Wales, AustraliaFaculty of Health, School of Nursing, York University, Toronto, Ontario, CanadaThe George Institute for Global Health at Peking University Health Science Center, Beijing, China1 Health Services and Population Research, King`s College London, London, UKObjectives 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.https://bmjopen.bmj.com/content/10/9/e037079.full |
| spellingShingle | Najma Siddiqi Meena Daivadanam J Jaime Miranda Trishul Siddharthan John R Hurst Rajesh Vedanthan Gary Parker Gina Agarwal Shabbar Jaffar Naomi Levitt Niels H Chavannes Pallab K Maulik Patricio Lopez-Jaramillo Kamran Siddiqi Muralidhar M Kulkarni Gillian Sandra Gould Job F M van Boven Kirsten Bobrow M O Owolabi Joan B Soriano Erick Wan-Chun Huang Shahirose Sadrudin Premji Lijing Yan Ricardo Araya F Xavier Gómez-Olivé Bruce J Kirenga Rianne M J J van der Kleij Laura Loli-Dano Shane Norris Josefien van Olmen Antigona C Trofor 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 BMJ Open |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://bmjopen.bmj.com/content/10/9/e037079.full |
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