Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;24(2):556-565.
doi: 10.1111/hex.13200. Epub 2021 Feb 17.

A scoping Review of tools used to assess patient Complexity in rheumatic disease

Kara Hawker  1 , Cheryl Barnabe  1   2 , Claire E H Barber  1   2
Affiliations

A scoping Review of tools used to assess patient Complexity in rheumatic disease

Kara Hawker et al. Health Expect. 2021 Apr.

Abstract

Objective: Patients with rheumatic diseases often have multiple comorbidities which may impact well-being leading to high psychosocial complexity. This scoping review was undertaken to identify complexity measures/tools used in rheumatology that could help in planning and coordinating care.

Methods: MEDLINE, EMBASE and CINAHL were searched from database inception to 14 December 2019 using keywords and Medical Subject Headings for "care coordination", "complexity" and selected rheumatic diseases and known complexity measures/tools. Articles describing the development or use of complexity measures/tools in patients with adult rheumatologic diagnoses were included regardless of study design. Included articles were evaluated for risk of bias where applicable.

Results: The search yielded 407 articles, 37 underwent full-text review and 2 were identified during a hand search with 9 included articles. Only 2 complexity tools used in populations of adult patients with rheumatic disease were identified: the SLENQ and the INTERMED. The SLENQ is a 97-item patient needs questionnaire developed for patients with systemic lupus (n = 1 study describing tool development) and applied in 5 cross-sectional studies. Three studies (a practice article, trial and a cross-sectional study) applied the INTERMED, a clinical interview to ascertain complexity and support coordinated care, in patients with rheumatologic diagnoses.

Conclusions: There is limited information on the use of patient complexity measures/tools in rheumatology. Such tools could be applied to coordinate multidisciplinary care and improve patient experience and outcomes.

Patient contribution: This scoping review will be presented to patient research partners involved in co-designing a future study on patient complexity in rheumatic disease.

Keywords: Care coordination; Rheumatoid Arthritis; Rheumatology; Systemic Lupus Erythematosus.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram outlining iterative steps performed in this scoping review
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Manning E, Gagnon M. The complex patient: a concept clarification. Nurs Health Sci. 2017;19(1):13‐21. - PubMed
    1. Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. Ann Fam Med. 2009;7(4):357‐363. - PMC - PubMed
    1. Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129‐136. - PubMed
    1. Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry. 1980;137(5):535‐544. - PubMed
    1. Safford MM, Allison JJ, Kiefe CI. Patient complexity: more than comorbidity. the vector model of complexity. J Gen Intern Med. 2007;22(Suppl 3):382‐390. - PMC - PubMed

Publication types

Grants and funding

LinkOut - more resources