How to design and evaluate interventions to improve outcomes for patients with multimorbidity

Abstract

Multimorbidity is a major challenge for patients and healthcare providers. The limited evidence of the effectiveness of interventions for people with multimorbidity means that there is a need for much more research and trials of potential interventions. Here we present a consensus view from a group of international researchers working to improve care for people with multimorbidity to guide future studies of interventions. We suggest that there is a need for careful consideration of whom to include, how to target interventions that address specific problems and that do not add to treatment burden, and selecting outcomes that matter both to patients and the healthcare system. Innovative design of these interventions will be necessary as many will be introduced in service settings and it will be important to ensure methodological rigour, relevance to service delivery, and generalizability across healthcare systems. Journal of Comorbidity 2013;3:10-17.

Keywords: Multimorbidity; comorbidity; complex evaluations; effectiveness; family practice; interventions.

Figure 1

Interventions for patients with multimorbidity. Although outlined in sequence, these interventions need to be considered in an iterative fashion as each issue informs previous and subsequent decision-making.