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. 2023 May 10;13(5):e063982.
doi: 10.1136/bmjopen-2022-063982.

Key characteristics of patient complexity and patient complexity conceptual models/measurement tools: a scoping review protocol

Rieko Mutai  1 , Yoshifumi Sugiyama  2   3 , Takuya Aoki  2 , Masato Matsushima  2
Affiliations

Key characteristics of patient complexity and patient complexity conceptual models/measurement tools: a scoping review protocol

Rieko Mutai et al. BMJ Open. .

Abstract

Introduction: The social determinants of health have been gaining recognition, confirming that multidimensional biopsychosocial assessment is essential to improving the health of individuals. This trend has led to the development of conceptual models and measurement tools assessing 'patient complexity', understood as a complex interplay of biopsychosocial factors, to improve the efficiency and effectiveness of care; however, the variety of meanings encompassed by the term has led to confusion in the interpretation of patient complexity such that there is no consensus regarding the definition or conceptualisation of patient complexity. The primary objective of this scoping review is to identify and map what is known about the key characteristics of patient complexity through multiple database searches.

Methods and analysis: This study will follow an established framework for conducting scoping reviews. The data will be extracted through searches of MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, The Cochrane Library and Google Scholar. Included articles will have: investigated participants aged 19 years or older, with any health condition; described patient complexity, a model for patient complexity, or a measurement tool for patient complexity; and been published in English from 1 January 1970 to April 2022. Article selection and data extraction will be conducted independently by two reviewers and if necessary for consensus, a third reviewer. A descriptive summary will be prepared to explain how the results apply to the scoping review questions. The findings will be a detailed mapping of the health dimensions that emerge from the classification of the extracted data. Subsequently, a definition of patient complexity will be developed.

Ethics and dissemination: This review does not require ethical approval, as we will use publicly available data. The study findings will be disseminated through a relevant conference presentation and a peer-reviewed journal. This protocol is registered on the Open Science Framework (www.osf.io/hpa3c).

Keywords: EPIDEMIOLOGY; GENERAL MEDICINE (see Internal Medicine); PRIMARY CARE.

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Conflict of interest statement

Competing interests: MM’s son-in-law is a past employee of IQVIA Services Japan K.K., a contract research organisation and a contract sales organisation, and a current employee of Syneos Health Clinical K.K., a contract research organisation and a contract sales organisation. All other authors declare no competing interests.

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