Cochrane Review Summary: Interventions for improving outcomes in patients with multimorbidity in primary care and community settings

Abstract

Included studies targeted people with multimorbidity, defined as two or more chronic conditions in the same person. The term comorbidity referred to combinations of defined conditions that commonly exist, for example, diabetes and heart disease. This Cochrane review contained 18 randomised-controlled trials (RCTs) of which nine targeted people with a broad range of conditions or multimorbidity (Smith et al., 2016). The remaining nine included comorbidities: depression with hypertension, headache, diabetes and/or heart disease and one study with a sub-group of people who had at least two of diabetes, chronic obstructive pulmonary disease and irritable bowel syndrome. Most studies evaluated interventions involving changes to the organisation of care delivery with some studies delivering more patient-focussed interventions. Interventions were delivered in primary care or community settings and compared with usual care. In all, 16 studies were conducted in the United States, one in the United Kingdom and one in Canada. Studies that did not aim to specifically target multimorbidity were excluded.