Journal of multimorbidity and comorbidity最新文献

{"title":"Sex differences in functioning and disability among adults with cardiometabolic multimorbidity using Canadian longitudinal study on aging data: A cross-sectional study.","authors":"Nicole I Ketter, Isabelle Rash, Michelle C Yang, Sarah Park, Brodie M Sakakibara","doi":"10.1177/26335565251356668","DOIUrl":"https://doi.org/10.1177/26335565251356668","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic multimorbidity (CM), two or more of stroke, diabetes, and heart disease is increasing in prevalence and associated with a multiplicative mortality risk. Sex differences exist in disability outcomes for those with stroke, diabetes, and heart disease, and thus are likely for those with CM.</p><p><strong>Objectives: </strong>To assess 1) sex differences in the prevalence of CM, 2) sex differences in disability variables amongst those with CM, and 3) the predicted probabilities of disability among people with and without CM by sex.</p><p><strong>Methods: </strong>A secondary analysis using data from the Canadian Longitudinal Study on Aging (CLSA). The CLSA included a stratified, random sample of approximately 51,000 participants aged 45 to 85 at recruitment. Independent variables include depressive symptoms, pain, high blood pressure, eyesight, limitations with activities of daily living (ADL), and social participation.</p><p><strong>Results: </strong>A weighted population of 13,204,82 participants were included, 659,621 had CM. Males had a higher prevalence of CM than females, accounting for 62% of those with CM. Females with CM had a higher probability than males of reporting high depressive symptoms (females: 29% [95%CI:27%-31%], males: 21% [95%CI:19%-23%]), pain (females: 49% [95%CI:47%-52%], males: 41% [95%CI:39%-43%]), and limitations with ADL (females: 27% [95%CI:25%-29%], males: 11% [95%CI:10%-13%]) Males with CM had a higher probability than females of reporting infrequent social participation (females: 18% [95%CI:16%-20%], males: 23% [95%CI:21%-25%]).</p><p><strong>Conclusion: </strong>This study provides evidence on sex differences in the likelihood of reporting disability variables in individuals with CM. These insights into sex differences can inform targeted interventions and improve patient outcomes.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251356668"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of multimorbidity research in India: A scoping review.","authors":"Parul Puri, Siaa Girotra, Arpita Ghosh","doi":"10.1177/26335565251355837","DOIUrl":"10.1177/26335565251355837","url":null,"abstract":"<p><strong>Objectives: </strong>Demographic and epidemiological shifts have led to people living with coexisting health issues, known as 'multimorbidity'. Given India's aging population, rising noncommunicable disease burden, chronic infections, fragmented healthcare, and reliance on specialist care, a scoping review is needed to understand the extent and nature of research on multimorbidity in India.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed, Cochrane, and Embase for studies focused on multimorbidity, with information specifically from India. Two reviewers independently screened the results and extracted information on definitions, including use of cut-offs or a minimum number of conditions, data and methods, patterns, risk factors and outcomes. Results were synthesized using descriptive statistics and narrative synthesis.</p><p><strong>Results: </strong>Of 9954 identified studies, 100 were included in the final synthesis. Of these, 62 were secondary analyses, 35 collected primary data, and 3 used administrative data. Most studies defined multimorbidity as two or more chronic or long-term conditions but did not specify whether long-term infections or mental health conditions were included. The number of conditions varied between 4 and 22. Circulatory, endocrine-nutritional-metabolic, and respiratory diseases were most frequently included. Beyond simple disease counts, combinations were reported in 15 studies. Healthcare utilization, out-of-pocket expenditure, and quality of life were commonly studied, mostly using cross-sectional designs.</p><p><strong>Conclusion: </strong>A standardised panel of conditions with clear definitions is needed for measuring multimorbidity. Conditions should be ascertained through a combination of self-report, physical examinations, and laboratory investigations. Additionally, longitudinal studies focused on multimorbidity, and its outcomes are needed to strengthen evidence base in India.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251355837"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of using artificial intelligence derived clusters by health and social care need in primary care: A qualitative interview study with patients living with multiple long-term conditions, carers and health care professionals.","authors":"Sian Holt, Glenn Simpson, Miriam Santer, Hazel Everitt, Andrew Farmer, Kuangji Zhou, Zhiling Qian, Firoza Davies, Hajira Dambha-Miller, Leanne Morrison","doi":"10.1177/26335565251353016","DOIUrl":"10.1177/26335565251353016","url":null,"abstract":"<p><strong>Background: </strong>People living with MLTCs attending primary care often have unmet social care needs (SCNs), which can be challenging to identify and address. Artificial intelligence (AI) derived clusters could help to identify patients at risk of SCNs. Evidence is needed on views about the use of AI-derived clusters, to inform acceptable and meaningful implementation within interventions.</p><p><strong>Method: </strong>Qualitative semi-structured interviews (online and telephone), including a description of AI-derived clusters and a tailored vignette, with 24 people living with MLTCs and 20 people involved in the care of MLTCs (carers and health care professionals). Interviews were analysed using Reflexive and Codebook Thematic Analysis.</p><p><strong>Results: </strong>Primary care was viewed as an appropriate place to have conversations about SCNs. However, participants felt health care professionals lack capacity to have these conversations and to identify support. AI was perceived as a tool that could potentially increase capacity but only when supplemented with effective, clinical conversations. Interventions harnessing AI should be brief, be easy to use and remain relevant over time, to ensure no additional burden on clinical capacity. Interventions must allow flexibility to be used by multidisciplinary teams within primary care, frame messages positively and facilitate conversations that remain patient centered.</p><p><strong>Conclusion: </strong>Our findings suggest that implementing AI-derived clusters to identify and support SCNs in primary care is perceived as valuable and can be used as a tool to inform and prioritse effective clinical conversations. But concerns must be addressed, including how AI-derived clusters can be used in a way that considers personal context.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251353016"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deriving severity thresholds of treatment burden for the patient experience with treatment and self-management (PETS).","authors":"David T Eton, Kathleen J Yost","doi":"10.1177/26335565251350923","DOIUrl":"10.1177/26335565251350923","url":null,"abstract":"<p><strong>Objective: </strong>The Patient Experience with Treatment and Self-management (PETS) is a valid self-report measure of treatment burden. The objective of this analysis is to determine severity cut points for its scores.</p><p><strong>Methods: </strong>Data from two survey studies of adults with multimorbidity were used to determine estimates of low, moderate, and high burden for twelve PETS scores. Anchor-based analyses were used to map mean PETS scores onto scores of other self-report measures, including physical and mental health, self-efficacy, and activity limitations. Low, medium, and high scores on the anchors were based on published thresholds or tertile splits of score distributions. Mean PETS scores were compared across levels of the anchor variable using analysis of variance (ANOVA) then summarized to produce burden severity cut points.</p><p><strong>Results: </strong>Study 1 featured survey data from 332 adults with multimorbidity (mean age = 66 years, 56% female); study 2 featured survey data from 439 adults with multimorbidity (mean age = 60 years, 62% female). Anchor measures were correlated with PETS scores at rho≥ 0.30. ANOVAs comparing PETS scores across the levels of each anchor variable were all significant (<i>p</i>s< .001). Estimates were placed into data tables. Cut scores for discriminating treatment burden severity levels were identified as the midpoint between the mean PETS scores associated with adjacent anchor categories (e.g., low vs. medium and medium vs. high burden), rounded to the nearest whole number.</p><p><strong>Conclusions: </strong>Severity thresholds can improve the interpretability of PETS scores. The preliminary estimates derived require verification in future studies.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251350923"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions for the management of concomitant COPD and hypertension: A systematic review.","authors":"Sadan Taher, Aletta E Schutte, John R Hurst, Chris P Gale, Sameera Ansari","doi":"10.1177/26335565251341389","DOIUrl":"10.1177/26335565251341389","url":null,"abstract":"<p><p><b>Background:</b> Chronic obstructive pulmonary disease (COPD) and hypertension are prevalent public health burdens, with hypertension often co-existing in up to 65% of COPD patients and complicating patient management. While numerous clinical guidelines address these conditions individually, there is a scarcity of evidence-based interventions for managing both simultaneously. <b>Purpose:</b> This systematic review aimed to identify interventional studies targeting people with concomitant COPD and hypertension <b>Research Design:</b> The review followed PRISMA guidelines and was registered on PROSPERO (CRD42024533767). A comprehensive search was conducted across multiple databases, including PubMed, EMBASE, Scopus, CINAHL, the Cochrane Library and Cochrane Controlled Register of Trials. <b>Results:</b> The search yielded 3,348 records, of which three studies met the inclusion criteria. These studies examined interventions including oral nitrate supplementation, medication adherence management and a collaborative care model. One study reported a significant reduction in systolic blood pressure (SBP) and improvement in COPD-related outcomes, while the other two reported mixed effects. The collaborative care model notably reduced hospitalizations and healthcare costs. <b>Conclusions:</b> The findings highlight the limited and inconsistent evidence available for managing concomitant COPD and hypertension, reinforcing the need for further research on this topic. Despite frequent clinical encounters with patients having both conditions, practitioners lack a unified treatment strategy. Future studies should focus on developing comprehensive management approaches that address the complex interplay between COPD and hypertension, aiming to improve patients' health outcomes and deliver efficient healthcare.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251341389"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing telehealth for multimorbidity management in rural and remote areas: A scoping review of interventions, outcomes, and implementation dynamics.","authors":"Sage M C Ishimwe, Delia Hendrie, Timothy A Carey, Jacquita S Affandi, Ninh Thi Ha, Sue Critchley, Amna Mushtaq, Sayyida Anees, Harley Sitou, Chak Seng Song, Brian Leong, Anneli Robbshaw, Christopher M Reid, Dan Xu","doi":"10.1177/26335565251344433","DOIUrl":"10.1177/26335565251344433","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity, the coexistence of two or more chronic diseases, affects 37% of adults globally, especially in rural areas with limited healthcare access. This burden leads to poorer health outcomes. Telehealth offers a solution by improving access to care. This scoping review explored the use of telehealth for managing multimorbidity in rural and remote areas.</p><p><strong>Methods: </strong>A protocol was registered on Open Science Framework. Four databases were searched for peer-reviewed articles published in English from 2010 to 2024, focusing on telehealth interventions for multimorbidity in rural and remote areas.</p><p><strong>Results: </strong>Out of 9,090 screened records, 15 articles were included in the review. Eight articles reported health outcomes (including five randomised controlled trials), while seven identified facilitators and barriers. Telehealth interventions were categorised as synchronous (5/15) and asynchronous (10/15), and they predominantly targeted physical health conditions (73%). Mixed effects on physiological outcomes were noted, with some studies reporting reductions in blood pressure and glycated haemoglobin. Mental health outcomes generally showed significant reductions in depression and anxiety. Facilitators included telehealth infrastructure, stakeholder engagement, and digital literacy, while barriers reflected the opposite.</p><p><strong>Conclusion: </strong>This review highlights that telehealth interventions can be cost-effective and improve access and health outcomes in rural and remote areas. However, the variability in findings emphasises the need for standardised implementation and further research to ascertain reliability. Future studies should explore strategies to address barriers and optimise telehealth interventions for managing multimorbidity in these settings.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251344433"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the development and validation of a Core Set for exercise-based rehabilitation of adults with multiple long-term conditions (multimorbidity) based on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework.","authors":"Fanuel M Bickton, James R Manifield, Felix Limbani, Justin Dixon, Anne E Holland, Rod S Taylor, Claire Calderwood, Walter Wittich, Celia L Gregson, Martin Heine, Zahira Ahmed, Ronel Roos, Sally J Singh","doi":"10.1177/26335565251343923","DOIUrl":"10.1177/26335565251343923","url":null,"abstract":"<p><strong>Background: </strong>Core outcome sets for people with multiple long-term conditions (multimorbidity) intervention studies offer an opportunity to compare data across studies and countries. However, a key research gap remains: the development of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) Core Set for multimorbidity rehabilitation. ICF Core Sets are a selection of essential categories from the full ICF classification that are considered most relevant for describing the functioning of a person with a specific health condition or in a specific healthcare context. This study aims to develop and validate an ICF Core Set for exercise-based multimorbidity rehabilitation. Unlike system- or disease-specific rehabilitation, multimorbidity rehabilitation entails using a modified structure that accommodates all conditions that an individual with multimorbidity has.</p><p><strong>Methods: </strong>The three-phase, multi-method process created by the WHO and ICF Research Branch will be followed. The process will involve conducting four preparatory studies (phase 1), including (i) a systematic literature review (to examine researcher perspectives), (ii) a qualitative study (to examine patient perspectives), (iii) an expert survey (to examine health professional perspectives), and (iv) an empirical study (to examine clinical perspectives). This will be followed by an international consensus conference (phase 2) where lists of ICF categories resulting from phase 1 studies will be consolidated into a first version of an ICF Core Set for multimorbidity rehabilitation, which will be validated using an international comparative data analysis (phase 3).</p><p><strong>Conclusion: </strong>An ICF Core Set created for multimorbidity rehabilitation will (1) benefit patients with multimorbidity who are often excluded from clinical trials of single-disease rehabilitation programs, (2) ensure precise and comprehensive assessment and documentation of functioning and disability relevant to this patient population, (3) help rehabilitation providers and their patients and/or caregivers when setting rehabilitation goals and planning rehabilitative interventions to achieve those goals, (4) help researchers in the synthesis of evidence for multimorbidity rehabilitation and facilitate the comparability of data across studies and countries, and (5) provide the scientific basis from which assessment tools can be derived for use in clinical and research settings and health care administration.</p><p><strong>Trial registration: </strong>COMET database (https://www.comet-initiative.org/Studies/Details/3266).</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251343923"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary patterns and metabolic morbidities correlate among adolescents and young adults with HIV in Lagos, Nigeria: A cross-sectional study design.","authors":"Mobolaji Olagunju, Abideen Olurotimi Salako, Titilola Abike Gbaja-Biamila, Tomilola Musari-Martins, Priscilla Ngozi Ezemelue, Babasola Opaneye, Abubakar AhmadRufai Abubakar, Ibukun Oluwatomisin Odusote, Feyikemi Fasina, Adeniyi Adeyinka, Oreoluwa Alabi, Agatha Nkiru David, Lilian Ezechi, Oluwatosin O Odubela","doi":"10.1177/26335565251341388","DOIUrl":"https://doi.org/10.1177/26335565251341388","url":null,"abstract":"<p><strong>Background: </strong>The relationship between dietary patterns (DP) and health outcomes (elevated blood pressure, dyslipidaemia, hyperglycaemia, and body mass index) among adolescents and young adults (AYA) with HIV is not well understood. We aimed to identify dietary patterns and determinants associated with metabolic syndrome components among adolescents and young adults living with HIV in Lagos, Nigeria.</p><p><strong>Methods: </strong>We conducted a cross-sectional study among 180 participants at an ART clinic in Lagos. Information on sociodemographic and clinical characteristics, as well as 72-hour dietary recall were collected. Anthropometric measurements (BMI (kg/m²)) and blood pressure readings were collected. Blood samples were assayed for fasting blood sugar and lipid profiles. Statistical analysis was done using SPSS version 27, WHO Anthro Plus software.</p><p><strong>Results: </strong>The male-to-female ratio was 1:1. Four major DPs identified were DP 1 (higher consumption of beverages, vitamins, and vegetables); DP 2 (high intake of minerals, and fruits); DP3 (higher intake of carbohydrates, fat and oil); and DP4 (higher intake alcohol and vegetables). DP1 was associated with dyslipidaemia, underweight BMI and hyperglycaemia were associated with DP4, while DP2 had lower odds of overweight and elevated blood pressure.</p><p><strong>Conclusion: </strong>This outcome provides valuable insights into DPs and their association with metabolic co-morbidity among AYA with HIV. This will inform nutritional counselling and interventions to promote quality of life and health.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251341388"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the use of burden of treatment theory.","authors":"Rachel C Smyth, Georgia Smith, Emily Alexander, Carl R May, Frances S Mair, Katie I Gallacher","doi":"10.1177/26335565251314828","DOIUrl":"https://doi.org/10.1177/26335565251314828","url":null,"abstract":"<p><strong>Background: </strong>Treatment burden describes the workload undertaken by people with chronic illness and multimorbidity to manage their healthcare demands and the impact on their wellbeing. Burden of Treatment Theory (BOTT) describes the work that people with multimorbidity do to self-manage chronic illness/multimorbidity and the factors that affect capacity (personal and healthcare resources, support network) to meet treatment demands. Here we aim to identify and characterise the different applications of Burden of Treatment Theory in research; to explore the contribution of Burden of Treatment Theory to advancing knowledge and understanding of treatment burden and capacity issues and to identify critiques or limitations of Burden of Treatment Theory in research.</p><p><strong>Methods: </strong>Systematic review of BOTT research published in the English language. Databases searched were Web of Science, Scopus, Medline, CINAHL and medRxiv.org. We also consulted with experts in the field. Two reviewers screened titles, abstracts and papers and undertook data extraction. Quality appraisal was undertaken using adapted CASP checklists for qualitative studies and systematic reviews and a Mixed Studies Review checklist.</p><p><strong>Results: </strong>Thirty papers included: 16 qualitative studies; 5 systematic reviews; 3 protocols; 3 discussion papers, a theory conceptual paper, a realist review and a feasibility trial. Most (n=17) originated in UK, with 3 from Australia and Argentina, 2 from Norway and one each from United States and Malawi. Nine papers mentioned use of BOTT constructs but 21 additionally provided rationale for BOTT use and demonstrated engagement with the theory. Two papers adapted/refined BOTT to the context of their research focus. Twenty-seven studies prospectively outlined use of BOTT, with only 3 applying BOTT retrospectively to report study outputs and 'inform analysis' of findings.</p><p><strong>Conclusion: </strong>BOTT provides a useful conceptual, analytical and sensitising lens in studies focusing on both the characterisation and alleviation of treatment burden through healthcare interventions, and the constructs discussed are stable and applicable across multiple settings. Future research could include use by empirical researchers in contexts needing more adaptation and critical assessment.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251314828"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of built environment features with multimorbidity: A systematic review protocol.","authors":"Alistair L Carr, Philip Broadbent, Frederick K Ho, Bhautesh Jani, Jonathan R Olsen, Valerie Wells, Frances Mair","doi":"10.1177/26335565251333278","DOIUrl":"https://doi.org/10.1177/26335565251333278","url":null,"abstract":"<p><strong>Introduction: </strong>Preventing or delaying multimorbidity (people living with two or more chronic conditions) is a public health priority. It is currently uncertain if multimorbidity is associated with features of the built environment, a term describing human-made or modified features of the surroundings in which humans live.</p><p><strong>Aims: </strong>To undertake a systematic review of the literature to determine if built environment features and interventions are associated with multimorbidity and to review the analytical methods used and their implications for causal inference.</p><p><strong>Methods: </strong>Four databases will be searched (Medline, Embase, Science Citation Index Expanded, and Social Sciences Citation Index) using a prespecified search strategy that incorporates terms for both multimorbidity and the built environment, which includes aspects of neighbourhood design, transport interventions, natural environment, food environments, and housing. Inclusion criteria will include: 1) involves community-based adult populations not selected based on an index condition; and 2) a built environment exposure or intervention was assessed; and 3) outcomes include multimorbidity prevalence, incidence, or trajectory. Reference lists of included studies and previous reviews will also be searched. Two reviewers will independently screen, data extract, and quality appraise (using the ROBINS-E or RoB 2 tool). Results will be synthesised by meta-analysis or, if heterogeneity is too great, according to Synthesis without meta-analysis (SWiM) guidelines. Results will be grouped by type of exposure or intervention and by study quality.</p><p><strong>Conclusions: </strong>This systematic review will improve understanding of built environment associations with multimorbidity. It could identify aetiological pathways that support the development of multimorbidity-preventative strategies.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251333278"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}