Family Medicine and Community Health最新文献

{"title":"Frailty, multimorbidity and quality of life in an ageing population in Africa: a cross-sectional, population-based study in rural and urban Rwanda.","authors":"Michael Boah, Callixte Cyuzuzo, Francois Uwinkindi, Chester Kalinda, Tsion Yohannes, Carolyn Greig, Justine Davies, Lisa R Hirschhorn, Alemayehu Amberbir","doi":"10.1136/fmch-2025-003512","DOIUrl":"https://doi.org/10.1136/fmch-2025-003512","url":null,"abstract":"<p><strong>Objective: </strong>As populations age, multimorbidity and frailty have emerged as major health challenges. While their associations with disability and mortality are well documented, their impact on quality of life (QoL) in sub-Saharan Africa remains underexplored. We examined the associations between frailty, multimorbidity and QoL among older adults in Rwanda.</p><p><strong>Design: </strong>A cross-sectional population-based study. Multimorbidity was defined as having two or more chronic conditions, including hypertension, diabetes, heart disease and mental health conditions. Frailty scores were derived using the Fried phenotype, and QoL was measured using the European Health Instrument Survey-Quality of Life index (scaled 0%-100%). Sequential linear regression models were used to examine independent associations.</p><p><strong>Setting: </strong>Rural and urban settings of Rwanda.</p><p><strong>Participant: </strong>We analysed data from 4369 adults (≥40 years).</p><p><strong>Results: </strong>The mean QoL score was 48.2% (±15.6). Frailty and multimorbidity prevalence were 14.5% (95% CI 13.5 to 15.6) and 55.2% (95% CI 53.7 to 56.6), respectively, while 55.0% (95% CI 53.3 to 56.3) were classified as prefrail. Frailty and multimorbidity are independently associated with poorer QoL. Compared with robust individuals, prefrail and frail individuals experienced a 3.66 (95% CI -4.63 to -2.70) and 7.30 (95% CI -8.76 to -5.83) percentage point reduction in QoL, respectively. Multimorbidity was associated with a 4.66% (95% CI -5.54 to -3.79) point decrease in QoL. Impairments in activities of daily living partly mediated these associations.</p><p><strong>Conclusions: </strong>Frailty and multimorbidity showed a strong negative association with QoL, with frailty having a stronger effect. These findings underscore the need for age-responsive healthcare strategies, including frailty screening and integrated chronic care, to enhance QoL among older adults in Rwanda.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Referrals to allied health professionals for people with dementia: an analysis of general practitioner data from two Australian primary health networks.","authors":"Den-Ching A Lee, Taya A Collyer, Grant Russell, Nadine E Andrew, Claire M C O'Connor, Keith D Hill, Kate Swaffer, Natasha Layton, Velandai Srikanth, Barbara Barbosa Neves, Lee-Fay Low, Yalchin Oytam, Galina Daraganova, Catherine Devanny, Michele L Callisaya","doi":"10.1136/fmch-2025-003470","DOIUrl":"10.1136/fmch-2025-003470","url":null,"abstract":"<p><strong>Objective: </strong>To examine general practitioners' (GPs) referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks (PHNs).</p><p><strong>Design: </strong>A retrospective cohort study using routinely collected general practice data. Logistic regression was used to compare odds of allied health referrals, adjusting for age, sex and socioeconomic status.</p><p><strong>Setting: </strong>De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.</p><p><strong>Participants: </strong>Data from 1 153 304 patients and 28 667 517 GP episodes of care were analysed. After merging records, 693 328 unique patients were identified, including 16 610 patients with dementia. Subcohorts included patients with dementia, stroke, Parkinson's disease and combinations of these conditions.</p><p><strong>Results: </strong>The dementia cohort (n=16 610) had a similar overall allied health referral rate (36.1%) to the control cohort (n=48 977) (35.4%). Patients with dementia only were significantly less likely to receive any allied health referral compared with those with stroke (adjusted OR (aOR) 0.76, 95% CI 0.72 to 0.80; p<0.001) or Parkinson's disease (aOR 0.72, 95% CI 0.66 to 0.78; p<0.001). Those with dementia and stroke were also less likely to receive referrals than those with stroke only (aOR 0.71, 95% CI 0.61 to 0.82; p<0.001). No significant difference was found between dementia with Parkinson's and Parkinson's only groups (p=0.48). Patients with dementia were consistently less likely to be referred to key allied health services (p<0.05).</p><p><strong>Conclusion: </strong>Despite strong evidence supporting allied health interventions for dementia, referral rates remain comparatively low. Enhancing GP referral resources and education, integrating dementia-specific care pathways and implementing supportive policy changes are needed to improve access and equity in dementia care.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do future general practitioners think about their training pathway? Findings from a nationwide survey in Italy.","authors":"Annette Corraro, Luigi Maria Bracchitta, Martina Consoloni, Pier Mannuccio Mannucci, Alessandro Nobili","doi":"10.1136/fmch-2025-003555","DOIUrl":"10.1136/fmch-2025-003555","url":null,"abstract":"","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based implementation of lifestyle medicine in healthcare practice: a research agenda.","authors":"Rimke C Vos, L A D M van Osch, J H M van Bilsen, M J Knapen, A W M Evers, M T E Hopman, L A L M Kiemeney, S Wopereis, Niels H Chavannes, Jessica C Kiefte-de Jong, Jochen Mierau, Stef Kremers","doi":"10.1136/fmch-2025-003324","DOIUrl":"10.1136/fmch-2025-003324","url":null,"abstract":"<p><p>In recent years, significant insights have been gathered into the effectiveness of lifestyle interventions in the treatment of chronic non-communicable diseases (NCD). To speed up the implementation of evidence-based lifestyle medicine, we developed a research agenda in collaboration with Dutch experts in treating NCD, using a hybrid Delphi approach. The research agenda focuses on four key themes: (1) promoting sustainable behavioural change at patient, healthcare professional and organisational levels; (2) optimising research designs, methodology and outcomes for the evaluation of effectiveness and implementation of lifestyle medicine modalities in healthcare practice; (3) elucidating biological mechanisms underlying successful lifestyle interventions and (4) advancing data infrastructure to ensure accessible data for citizens, healthcare professionals, researchers and health insurers for monitoring and evaluation of health and lifestyle outcomes. Collectively, the identified knowledge questions across these four themes provide guidance for (applied) research towards lifestyle medicine in healthcare.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trial-based economic evaluations of non-drug interventions in the Royal Australian College of General Practitioners (RACGP) Handbook of Non-Drug Interventions in primary care: a systemic review.","authors":"Tiffany Atkins, Darryn Marks, Caroline Dowsett, Paul Glasziou, Loai Albarqouni","doi":"10.1136/fmch-2025-003312","DOIUrl":"10.1136/fmch-2025-003312","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review assessed trial-based economic evaluations to provide empirical evidence on the cost-effectiveness of non-drug interventions (NDIs) that are currently recommended within the Royal Australian College of General Practitioners Handbook of Non-Drug Interventions (HANDI).</p><p><strong>Methods: </strong>Medline, CINAHL and PsycINFO along with clinical trial registries (clinicaltrials.gov and WHO International Clinical Trials Registry Platform) were searched from inception to 1 July 2025. Randomised controlled trials (RCTs) that reported cost effectiveness for a prescribed non-drug intervention (NDI) from HANDI were included in the study. The primary outcome was the incremental cost-utility ratio (ICUR) derived from cost-utility analyses (CUAs).</p><p><strong>Results: </strong>A total of 11 187 citations were identified, from which 156 RCTs were included. These RCTs enrolled a total of 66 926 participants (median=214, IQR 139-342), with a median follow-up duration of 12 months (IQR 6-12 months). Over half of the CUA NDIs were for mental health conditions (n=81; 54.0%), one-third were for were for musculoskeletal conditions (n=44; 29.3%), while only 16.0% (n=24) were for those with cardiovascular/metabolic conditions. Out of the 150 NDIs that reported CUAs, 40% were deemed to be in the south-east (SE) quadrant (cheaper and more effective) and 49.3% fell in the north-east (NE) quadrant (more costly but more effective), with 70% considered cost effective against a £25 000/quality-adjusted life-year (QALY) willingness to pay threshold. The overall median ICUR was £2400/QALY (IQR -18 986 to 20 027).</p><p><strong>Conclusions: </strong>Most of the HANDI NDIs that were included within this systematic review are cost-effective compared with a variety of alternatives including usual care or waiting list controls. HANDI NDIs warrant use as a first line of treatment when clinically appropriate.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up of grieving families in general and family medicine: a cross-sectional study on the practices and attitudes of family doctors.","authors":"Fábio Leite Costa, Miguel Barbosa","doi":"10.1136/fmch-2025-003296","DOIUrl":"10.1136/fmch-2025-003296","url":null,"abstract":"<p><strong>Introduction: </strong>Family physicians (FPs) provide essential support during life's most challenging moments, including experiences of grief and loss. After a patient's death, FPs are expected to provide information and emotional support to bereaved family members. Prior research suggests that bereaved relatives expect follow-up contact from their FP, acknowledging it as part of the physician's role. This study aims to explore the practices and attitudes of FPs towards bereaved family members.</p><p><strong>Methods: </strong>A cross-sectional, descriptive study was conducted through an online questionnaire, exploring participants' perceived role in bereavement care, the type of support offered to families, available resources in primary care, as well as personal knowledge and approach on grief. This questionnaire was distributed via digital platforms to general and family medicine doctors.</p><p><strong>Results: </strong>A total of 210 physicians participated (84.3% female; 53.8% in residency), with a median age of 32 years old. On average, each FP experienced five patient deaths, most often reported by family members. More than half (53.3%) contacted bereaved families in fewer than 25% of cases, typically within 7 days of the death, most commonly by phone (76.5%).</p><p><strong>Conclusion: </strong>This study highlights significant gaps in the bereavement follow-up practices of FPs in Portugal. Findings emphasise the need for integrated bereavement care guidelines in primary care, institutional policies and investment in targeted training programmes to enhance grief's approach. The reported lack of grief training reinforces the need to integrate grief education into medical curriculum and continuous professional development. Structural improvements, such as the implementation of automatic death notifications within the healthcare system, are also critical for enabling timely and effective support.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco and other substance co-use among adolescents and young adults with cancer who use tobacco: prevalence and associations with nicotine dependence and depression.","authors":"Elizabeth J Siembida, Brittney Greene, Eun Jeong Oh, Kara P Wiseman, Melissa Basile, Nehal P Vadhan, Michael A Diefenbach","doi":"10.1136/fmch-2025-003362","DOIUrl":"10.1136/fmch-2025-003362","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco and other substance co-use has not been examined in adolescent and young adult (AYA) cancer survivors. We compared the prevalence of past-month co-use of tobacco+cannabis, alcohol and illicit drugs between AYAs with and without a cancer history and considered associations between co-use and nicotine dependence in AYA cancer survivors who use tobacco, exploring if past-year major depression moderates this relationship.</p><p><strong>Methods: </strong>2015-2019 National Survey on Drug Use and Health data were used to analyse past-month co-use in 7793 AYAs (228 with cancer; 7565 without cancer). Weighted univariable and multivariable logistic regression models estimated associations between cancer history and co-use and co-use with nicotine dependence (among AYA cancer survivors) incorporating moderation by major depression.</p><p><strong>Results: </strong>AYA cancer survivors had lower reported past-month cannabis co-use than those without cancer (29% vs 39%), but cancer history was not associated with cannabis co-use in multivariable models (adjusted OR (aOR): 0.83, 95% CI=0.54, 1.28). When AYA cancer survivors who use tobacco had major depression, alcohol co-use was associated with lower rates of nicotine dependence (aOR=0.08, 95% CI=0.01, 0.53).</p><p><strong>Conclusions: </strong>There are high rates of substance co-use among AYAs who use tobacco, consistent across cancer history. Unlike previous research, alcohol co-use was associated with lower rates of nicotine dependence, but only for those with major depression. This finding could be related to neurochemical dysregulation due to co-use and warrants further exploration. Future research should also examine more nuanced definitions of substance use including modes, patterns and initiation of use, and explore motivation to change tobacco behaviour in AYA cancer survivor populations.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM.","authors":"Anna Bernhardt Lyhnebeck, Anne Holm, Sussi Friis Buhl, Kristine Henderson Bissenbakker, Jette Kolding Kristensen, Anne Møller, Anders Prior, Zaza Kamper-Jørgensen, Sidsel Böcher, Mads Kristensen, Asger Waagepetersen, Anders Hye Dalsgaard, Volkert Siersma, John Brandt Brodersen","doi":"10.1136/fmch-2025-003378","DOIUrl":"10.1136/fmch-2025-003378","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to either identify or develop and validate a patient-reported outcome measure (PROM) to assess treatment burden related to general practice for patients with multimorbidity, which can be used alongside the MultiMorbidity Questionnaire part 1 (MMQ1) without overwhelming the target population with redundant items.</p><p><strong>Methods: </strong>We conducted a systematic literature review to identify all existing PROMs measuring treatment burden. If no suitable PROM was found, our plan was to: (1) develop a draft PROM using items from existing instruments, (2) carry out group and individual interviews with patients with multimorbidity to ensure the PROM's understandability, clarity, completeness and relevance and (3) undertake psychometric validation with a diverse sample of primary care patients with chronic conditions.</p><p><strong>Results: </strong>We did not identify an eligible PROM in the literature review. The draft PROM consisted of 30 items divided into six domains; Information about treatment, Challenges with medication, Medical appointments, Self-monitoring, Health behaviour and Challenges in the contact to the health system. In the psychometric validation, neither these domains nor any other theoretical constellation of items had adequate psychometric properties. Individual items had good criterion validity and sensitivity to change.</p><p><strong>Conclusions: </strong>In this study, we developed a 30-item PROM with high content validity where various individual items showed adequate criterion validity and sensitivity to change, making these items useful as a supplemental measure to the MMQ1.</p><p><strong>Trial registration number: </strong>NCT05676541 Registration Date: 16 December 2022.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Process for mainstreaming genetic cascade testing into primary and tertiary health systems in familial hypercholesterolaemia (FH), an autosomal dominant, fully penetrant disorder.","authors":"Karen L Birkenhead, David Sullivan, Madeline Calder, Catherine Spinks, Gabrielle Fleming, Claire Trumble, Cameron Hemmert, Ronald Trent, Shubha Srinivasan, Kerrie Martin, Bridie Carr, Charlotte M Hespe, Mitchell Sarkies","doi":"10.1136/fmch-2024-003258","DOIUrl":"10.1136/fmch-2024-003258","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in clinical genomics have raised the importance of integrating genomic medicine across healthcare systems, including primary care. Primary care presents an ideal environment to offer equitable and efficient access to genetic services. Familial hypercholesterolaemia (FH) is a preventable and treatable cause of premature heart disease and represents a health condition that can be successfully diagnosed and managed in primary care. This study describes a process for tailoring a primary-tertiary shared care model for FH to optimise health professional and patient engagement.</p><p><strong>Methods: </strong>Data were collected through semistructured interviews (n=10) with stakeholders in New South Wales, Australia. Interviews gathered feedback on how to tailor a shared care model for FH between tertiary and primary care services. Reflexive thematic analysis was used to analyse interview transcripts.</p><p><strong>Results: </strong>Analysis generated three main themes: (1) current process for genetic testing and management, (2) challenges with genetic testing for FH in primary care and (3) components needed to enable a tertiary-initiated shared care model. Participants considered the model of care acceptable and could be successfully implemented, provided key supports were in place to assist general practitioners. Based on these results, a process model for integrating genetic testing for other conditions into primary care settings was developed, using FH as an exemplar.</p><p><strong>Conclusion: </strong>The process model for tailoring of a primary-tertiary model of care for FH can be applied across a range of primary care services and treatable genetic conditions.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global evidence on the effectiveness of task-shifting and task-sharing strategies for managing individuals with multimorbidity: systematic review and meta-analysis.","authors":"Enying Gong, Yutong Long, Xunliang Tong, Wai Yan Min Htike, Jiahui Wang, Shiqi Ni, Yueqing Wang, Zijun Wang, Lijing L Yan, Sumit Kane, Ruitai Shao, Yanming Li","doi":"10.1136/fmch-2025-003390","DOIUrl":"10.1136/fmch-2025-003390","url":null,"abstract":"<p><strong>Introduction: </strong>Task-shifting and task-sharing strategies show promise for managing chronic diseases especially in low-income and middle-income countries (LMICs), though their effectiveness in multimorbidity management remains unclear. This study synthesised evidence on task-shifting and task-sharing strategies globally and assessed the impact on core health outcomes in multimorbidity management.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of global studies evaluating task-shifting and sharing interventions for individuals with multimorbidity. Six databases, including PubMed, Embase, Web of Science, Ovid (Medline), CINAHL and Cochrane Library, were searched for studies reporting the core outcomes of multimorbidity management in quality of life, mortality, hospitalisation, emergency department visits and symptoms of depression and anxiety. Random-effects models were used to calculate pooled effect sizes with heterogeneity assessed through subgroup and meta-regression analyses.</p><p><strong>Results: </strong>From 8471 records, 36 studies from 14 countries were included, with only 5 conducted in LMICs. Twenty-one studies, encompassing 20 989 participants, were eligible for meta-analysis. More than half of the studies involved nurses as delegates, with some sharing the tasks with health professionals and about 10% of studies involved non-health professionals, including community healthcare workers as delegates to share the responsibility in caring for individuals with multimorbidity. Most studies were multicomponent, with 16.7% addressing all guideline-recommended aspects of multimorbidity management. By pooling the findings, task-shifting and task-sharing interventions were associated with a 27% reduction in mortality (OR: 0.73, 95% CI: 0.55 to 0.97, I²=0%), a modest improvement in quality of life (standardised mean difference (SMD): 0.1, 95% CI: 0.03 to 0.17, I²=47%) and reduced symptoms of depression (SMD: 0.27, 95% CI: -0.52 to -0.02, I²=90%), but showed no significant effect on hospitalisation, emergency visits or anxiety-related symptoms.</p><p><strong>Conclusions: </strong>Some evidence, although limited in existing research, indicates the great potential of task-shifting and task-sharing strategies in supporting management of multimorbidity. Further research is needed to optimise and adopt these interventions, particularly in LMICs where evidence remains scarce.</p><p><strong>Prospero registration number: </strong>CRD42024526845.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}