Journal of multimorbidity and comorbidity最新文献

{"title":"Study protocol for a multicenter randomized controlled trial of personalized exercise therapy and self-management support for people with multimorbidity: The MOBILIZE study.","authors":"Søren T Skou, Mette Nyberg, Mette Dideriksen, Jan A Overgaard, Christine Bodilsen, Anne Mb Soja, Amir P Attarzadeh, Manuel J Bieder, Nadia P Dridi, Andreas Heltberg, Peter H Gæde, Johan L Reventlow, Sidse Arnfred, Uffe Bodtger, Lau C Thygesen, Madalina Jäger, Alessio Bricca","doi":"10.1177/26335565231154447","DOIUrl":"10.1177/26335565231154447","url":null,"abstract":"<p><strong>Background: </strong>Despite the great individual and societal burden associated with multimorbidity, little is known about how to effectively manage it.</p><p><strong>Objective: </strong>The aim of this multicenter randomized controlled trial (RCT) is to investigate the 12-month effects of a personalized exercise therapy and self-management support program in addition to usual care in people with multimorbidity.</p><p><strong>Design: </strong>This is a protocol for a pragmatic, parallel-group (1:1 ratio), superiority RCT conducted at five intervention sites (two hospitals, a private practice physiotherapy clinic and two municipal rehabilitation centers) in Region Zealand, Denmark. A total of 228 persons with multimorbidity aged 18 years or older, will be randomly allocated to one of two groups. Both groups will receive usual care, defined as routine care for multimorbidity at the discretion of the treating doctor, while the intervention group will also participate in a 12-week exercise therapy and self-management support program tailored to people with multimorbidity at one of the intervention sites. The primary outcome will be the between-group difference in change in EQ-5D-5L from baseline to the follow-up at 12 months. Secondary outcomes include objectively-measured physical function and physical activity, inflammatory markers, disease and treatment burden, anxiety, depression, stress, sleep, pain and other self-reported parameters. In parallel with the RCT, an observational cohort will follow persons aged ≥18 years with multimorbidity not adhering to all eligibility criteria, as well as people fulfilling all eligibility criteria, but unwilling to participate in the RCT. This study was approved by the Regional Committee on Health Research Ethics for Region Zealand (SJ-857) and results will be communicated in scientific papers, at relevant conferences and to a broader audience.</p><p><strong>Discussion: </strong>Exercise therapy and self-management support is safe and effective in people with single conditions. However, it is still unclear whether this holds true for individuals with multimorbidity. This pragmatic, multicenter RCT will provide high-quality evidence on the benefits and harms of exercise therapy and self-management support and, if the results support it, lead to the development of a plan for implementation in clinical practice.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231154447"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/25/10.1177_26335565231154447.PMC9903016.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10816779","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":"COVID 19 prevention practice of patients with known chronic illness in Ethiopia: A systemic review and meta-analysis.","authors":"Amare Zewdie,&nbsp;Ayenew Mose,&nbsp;Tadesse Sahle,&nbsp;Abebaw Wasie Kasahun,&nbsp;Elyas Melaku,&nbsp;Melkamu Aderajew Zemene","doi":"10.1177/26335565231176166","DOIUrl":"https://doi.org/10.1177/26335565231176166","url":null,"abstract":"<p><strong>Introduction: </strong>There were different studies done and found a highly variable level of COVID 19 prevention practice; however, there was no summarized evidence on the prevention practice of chronic disease patients in Ethiopia. This systematic review and meta-analysis aims to assess the pooled prevalence of COVID 19 prevention practice and associated factors among chronic disease patients in Ethiopia.</p><p><strong>Method: </strong>Systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in international databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I² statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify determinants of COVID 19 prevention practice.</p><p><strong>Result: </strong>Overall, 437 articles were retrieved and finally 8 articles were included in this review. The pooled prevalence of good COVID 19 prevention practices was 44.02% (95%CI (35.98%-52.06%). Being rurally reside (AOR = 2.39, 95% CI (1.30-4.41)), having educational status of cannot read and write (AOR = 2.32, 95% CI (1.22-4.40)), and poor knowledge (AOR = 2.43, 95% CI (1.64-3.60)) positively associated with poor practice.</p><p><strong>Conclusion: </strong>Good COVID 19 prevention practices of chronic disease patients in Ethiopia was low. Rural residence, educational status of cannot read and write and poor knowledge was positively associated with poor practice. Therefore, policymakers and program planners should target those high-risk groups in improving their awareness to enhance their practice specifically focusing on those who are rural reside and with low educational status.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231176166"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/dd/10.1177_26335565231176166.PMC10184217.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298354","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":"Mortality among Canadian population with multimorbidity: A retrospective cohort study.","authors":"Xiang Xiao,&nbsp;Jeremy Beach,&nbsp;Ambikaipakan Senthilselvan","doi":"10.1177/26335565231157626","DOIUrl":"https://doi.org/10.1177/26335565231157626","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine the effect of multimorbidity and the joint effect of chronic diseases on all-cause mortality among subjects aged 35 years and above.</p><p><strong>Study design: </strong>Population-based retrospective cohort study.</p><p><strong>Methods: </strong>Multimorbidity was defined by the respondent's self-report of having two or more chronic diseases of the nine considered. The Canadian Community Health Surveys conducted in 2003/2004, 2005/2006 and 2007 to 2014 were linked with the Canadian Vital Statistics Death Database to examine the association between multimorbidity and all-cause mortality in subjects aged 35 years and above. Cox's proportional hazards models were used to estimate risk of multimorbidity on death after adjusting for the confounders in three age groups.</p><p><strong>Results: </strong>Multimorbidity had an increased risk of death in all three age groups with the youngest having the highest risk after adjusting for potential confounders (35 to 54 years: hazard ratio (HR) = 3.77, 95% CI: 3.04, 4.67; 55 to 64 years: HR = 2.64, 95% CI: 2.36, 2.95; 65 years and above: HR = 1.71; 95% CI:1.63,1.80). Subjects with cancer had the highest risk of death in the three age groups. When the interactions between chronic diseases were considered, subjects with COPD and diabetes had a significantly increased risk of death in comparison to those without COPD or diabetes in the 55 to 64 years. (HR = 2.59, 95% CI: 2.01, 3.34).</p><p><strong>Conclusions: </strong>Prevention of multimorbidity should be targeted not only in the older population but also in the younger populations. Synergistic effects of chronic diseases should be considered in the management of multimorbidities.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231157626"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9940159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10770603","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":"Management of multimorbidity.","authors":"Alessio Bricca,&nbsp;Susan M Smith,&nbsp;Søren T Skou","doi":"10.1177/26335565231156693","DOIUrl":"https://doi.org/10.1177/26335565231156693","url":null,"abstract":"Multimorbidity is a global challenge with substantial impact on individuals, health-care systems, and society. More than 3 out of 4 consultations in primary care involve multimorbidity and the relationship between the number of chronic conditions and their associated cost is almost exponential. Managing multimorbidity is complex, given the need to address management of individual conditions while incorporating patient preferences. A range of management strategies have been evaluated and the current evidence base includes more than 40 trials. Nevertheless, there is still limited high-quality evidence to guide clinical practice (Table 1).This Editorial highlights management approaches that have potential to improve outcomes for patients with multimorbidity.","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231156693"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/cb/10.1177_26335565231156693.PMC9996704.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9487658","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":"Patterns of multimorbidity among a community-based cohort in rural India.","authors":"Balaji Gummidi,&nbsp;Vaishali Gautam,&nbsp;Oommen John,&nbsp;Arpita Ghosh,&nbsp;Vivekanand Jha","doi":"10.1177/26335565221149623","DOIUrl":"https://doi.org/10.1177/26335565221149623","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity estimates are expected to increase in India primarily due to the population aging. However, there is a lack of research estimating the burden of multimorbidity in the Indian context using a validated tool. We estimated the prevalence and determinants of multimorbidity amongst the adult population of the rural Uddanam region, Andhra Pradesh.</p><p><strong>Methods: </strong>This community-based cross-sectional study was conducted as a part of an ongoing research program. Multistage cluster sampling technique was used to select 2419 adult participants from 40 clusters. Multimorbidity was assessed using Multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC) tool, collecting information on 13 chronic diseases. Patient Health Questionnaire (PHQ-12) was used to screen for depression. Multiple logistic regression was conducted to identify the strongest determinants of multimorbidity.</p><p><strong>Results: </strong>Of the 2419 participants, 2289 completed the MAQ-PC tool. Mean age (standard deviation) of participants was 48.1 (13.1) years. The overall prevalence of multimorbidity was 58.5% (95% CI 56.5-60.6); with 30.7%, 15.6%, and 12.2% reporting two, three, and four chronic conditions, respectively. Acid peptic disease-musculoskeletal disease (44%) and acid peptic disease-musculoskeletal disease-hypertension (14.9%) were the most common dyad and triad. Among metabolic diseases, diabetes-hypertension (28.3%) and diabetes-hypertension-chronic kidney disease (7.6%) were the most common dyad and triad, respectively. Advancing age, female gender, and being obese were the strongest determinates of the presence of multimorbidity. Depression was highly prevalent among the study population, and participants with higher PHQ-12 score had 3.7 (2.5-5.4) greater odds of having multimorbidity.</p><p><strong>Conclusions: </strong>Our findings suggest that six of 10 adults in rural India are affected with multimorbidity. We report a higher prevalence of multimorbidity as compared with other studies conducted in India. We also identified vulnerable groups which would guide policy makers in developing holistic care packages for individuals with multimorbidity.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565221149623"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/d6/10.1177_26335565221149623.PMC9832245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540971","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":"Multimorbidity prevalence and patterns at the baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).","authors":"Larissa Pruner Marques,&nbsp;Odaleia Barbosa de Aguiar,&nbsp;Daniela Polessa Paula,&nbsp;Fernanda Esthefane Garrides Oliveira,&nbsp;Dóra Chor,&nbsp;Isabela Benseñor,&nbsp;Antonio Luiz Ribeiro,&nbsp;Andre R Brunoni,&nbsp;Luciana A C Machado,&nbsp;Maria de Jesus Mendes da Fonseca,&nbsp;Rosane Härter Griep","doi":"10.1177/26335565231173845","DOIUrl":"https://doi.org/10.1177/26335565231173845","url":null,"abstract":"<p><strong>Background: </strong>To identify multimorbidity patterns, by sex, according to sociodemographic and lifestyle in ELSA-Brasil.</p><p><strong>Methods: </strong>Cross-sectional study with 14,516 participants from ELSA-Brasil (2008-2010). Fuzzy c-means was used to identify multimorbidity patterns of 2+ chronic morbidities, where the consequent morbidity had to occur in at least 5% of all cases. Association rule (O/E≥1.5) was used to identify co-occurrence of morbidities, in each cluster, by sociodemographic and lifestyle factors.</p><p><strong>Results: </strong>The prevalence of multimorbidity was higher in women (73.7%) compared to men (65.3%). Among women, cluster 1 was characterized by hypertension/diabetes (13.2%); cluster 2 had no overrepresented morbidity; and cluster 3 all participants had kidney disease. Among men, cluster 1 was characterized by cirrhosis/hepatitis/obesity; cluster 2, most combinations included kidney disease/migraine (6.6%); cluster 3, no pattern reached association ratio; cluster 4 predominated co-occurrence of hypertension/rheumatic fever, and hypertension/dyslipidemia; cluster 5 predominated diabetes and obesity, and combinations with hypertension (8.8%); and cluster 6 presented combinations of diabetes/hypertension/heart attack/angina/heart failure. Clusters were characterized by higher prevalence of adults, married and participants with university degrees.</p><p><strong>Conclusion: </strong>Hypertension/diabetes/obesity were highly co-occurred, in both sexes. Yet, for men, morbidities like cirrhosis/hepatitis were commonly clustered with obesity and diabetes; and kidney disease was commonly clustered with migraine and common mental disorders. The study advances in understanding multimorbidity patterns, benefiting simultaneously or gradually prevention of diseases and multidisciplinary care responses.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231173845"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/0f/10.1177_26335565231173845.PMC10201182.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10290193","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":"Impact of US Medicare Coverage on Multimorbidity Accumulation Among Patients Seen in Community Health Centers","authors":"Katherine D Peak, Teresa D. Schmidt, Tahlia L. Hodes, Ana R. Quiñones, N. Huguet","doi":"10.1370/afm.21.s1.3975","DOIUrl":"https://doi.org/10.1370/afm.21.s1.3975","url":null,"abstract":"","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87331191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity in South Africa: Is the health system ready?","authors":"Rifqah Abeeda Roomaney,&nbsp;Brian van Wyk,&nbsp;Victoria Pillay-van Wyk","doi":"10.1177/26335565231182483","DOIUrl":"https://doi.org/10.1177/26335565231182483","url":null,"abstract":"<p><p><b>Background:</b> Multimorbidity is likely to be a significant contributor to ill health and inequality in South Africa and yet has been largely overlooked. <b>Purpose:</b> This paper focuses on the findings of a recent large study that highlighted emerging issues - namely (i) the high levels of multimorbidity among three key groups - older adults, women, and the wealthy; (ii) discordant and concordant disease clusters among the multimorbid. <b>Research Design:</b> Narrative. <b>Study Sample and Data Collection:</b> Not applicable. <b>Results:</b> We discuss the implications of each emerging issue for health systems policy and practice. <b>Conclusion:</b> Although key policies are identified, many of these policies are not implemented and are therefore not part of routine practice, leaving much space for improvement.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231182483"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/1c/10.1177_26335565231182483.PMC10278409.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10351479","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":"The association between physical activity, low-grade inflammation, and labour market attachment among people with multimorbidity: A cross-sectional study from the Lolland-Falster Health Study, Denmark.","authors":"Vivian Rueskov Poulsen,&nbsp;Linda Kjær Fischer,&nbsp;Mette Aadahl,&nbsp;Ole Steen Mortensen,&nbsp;Søren T Skou,&nbsp;Lars Bo Jørgensen,&nbsp;Randi Jepsen,&nbsp;Anne Møller,&nbsp;Therese Lockenwitz Petersen,&nbsp;Jan Christian Brønd,&nbsp;Lars Tang,&nbsp;Mette Korshøj","doi":"10.1177/26335565231195510","DOIUrl":"https://doi.org/10.1177/26335565231195510","url":null,"abstract":"<p><strong>Aim: </strong>Evidence suggests low-grade inflammation (LGI) to be associated with multimorbidity. Furthermore, there are links between inflammation markers, physical activity (PA), and labour market participation. The aims of this study were to examine the association between PA and LGI in people with multimorbidity and if this association was moderated by self-reported labour market attachment.</p><p><strong>Methods: </strong>Cross-sectional data were collected in the Lolland-Falster Health Study (LOFUS) from 2016-2020. We included 1,106 participants with multimorbidity and valid accelerometer data. PA was measured as the average counts per minute (CPM) per day during wake time and split in time spent in moderate to vigorous intensity (MVPA) and light intensity (LPA). Degree of inflammation was determined by high sensitive C-reactive protein (hsCRP) level. Associations were investigated using multiple logistic regression analyses, stratified by labour market attachment.</p><p><strong>Results: </strong>The odds of having LGI was higher with lower amount of daily LPA. The highest odds of LGI was observed for CPM < 200 per day (odds ratio (OR) 2.55; 95% confidence interval (CI) 1.46-4.43), MVPA < 15 minutes per day (OR 2.97; 95 % CI 1.56-5.62), and LPA < 90 (OR 2.89; 95 % CI 1.43-5.81) with the reference groups being CPM ≥ 400 per day, MVPA ≥ 30, and LPA ≥ 180 min per day, respectively. We could not preclude an interaction between LPA and labour market attachment (<i>p</i> = 0.109).</p><p><strong>Conclusion: </strong>PA recommendations should be developed with attention to people with chronic diseases, who may experience barriers to reach PA at high intensities. People with no labour market attachment may benefit from primary and secondary prevention of multimorbidity.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231195510"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/28/10.1177_26335565231195510.PMC10447179.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10356826","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 pilot, randomized, feasibility study to improve health self-management behaviors in older adults with multiple chronic conditions and functional limitations: Protocol for the Behavioral Activation and Occupational Therapy Trial (BA+OT).","authors":"Tara C Klinedinst,&nbsp;Carrie A Ciro,&nbsp;Darla E Kendzor","doi":"10.1177/26335565231163037","DOIUrl":"https://doi.org/10.1177/26335565231163037","url":null,"abstract":"<p><strong>Background: </strong>Approximately 45% of older adults in the U.S. have 2 or more chronic health conditions (e.g., arthritis, hypertension, diabetes) in addition to functional limitations that prevent performance of health self-management activities. Self-management continues to be the gold standard for managing MCC, but functional limitations create difficulty with these activities (e.g., physical activity, symptom monitoring). Restricted self-management accelerates the downward spiral of disability and accumulating chronic conditions which, in turn, increases rates of institutionalization and death by 5-fold. Currently, there are no tested interventions designed to improve independence in health self-management activities in older adults with MCC and functional limitations. Research suggests that older adults are more likely to change behavior with interventions that assist with planning health-promoting daily activities, especially when contending with complex medical regimens and functional limitations. Our team asserts that combining occupational therapy (OT) and behavioral activation (BA) shows promise to improve health self-management in populations with chronic conditions and/or functional limitations. This innovative combination uses the goal setting, scheduling/monitoring activities, and problem-solving components of the BA approach as well as the environmental modification, activity adaptation, and focus on daily routines from OT practice.</p><p><strong>Objectives: </strong>We will test the effect of this combined approach in a Stage I, randomized controlled pilot feasibility study compared to enhanced usual care. We will recruit 40 older adults with MCC and functional limitation and randomize 20 to the PI- delivered BA-OT protocol. This research will inform modification and larger-scale testing of this novel intervention.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231163037"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/8e/10.1177_26335565231163037.PMC9998403.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9157258","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}