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Title: Systematic review on the instruments used for measuring the association of the level of multimorbidity and clinically important outcomes
Authors: Lee, Eng Sing
Koh, Hui Li
Ho, Elaine Qiao-Ying
Teo, Sok Huang
Wong, Fang Yan
Ryan, Bridget L.
Fortin, Martin
Stewart, Moira
Keywords: Science::Medicine
Issue Date: 2021
Source: Lee, E. S., Koh, H. L., Ho, E. Q., Teo, S. H., Wong, F. Y., Ryan, B. L., Fortin, M. & Stewart, M. (2021). Systematic review on the instruments used for measuring the association of the level of multimorbidity and clinically important outcomes. BMJ Open, 11(5), e041219-.
Project: NMRC/CG/C019/2017
Journal: BMJ Open
Abstract: Objectives: There are multiple instruments for measuring multimorbidity. The main objective of this systematic review was to provide a list of instruments that are suitable for use in studies aiming to measure the association of a specific outcome with different levels of multimorbidity as the main independent variable in community-dwelling individuals. The secondary objective was to provide details of the requirements, strengths and limitations of these instruments, and the chosen outcomes. Methods: We conducted the review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number: CRD42018105297). We searched MEDLINE, Embase and CINAHL electronic databases published in English and manually searched the Journal of Comorbidity between 1 January 2010 and 23 October 2020 inclusive. Studies also had to select adult patients from primary care or general population and had at least one specified outcome variable. Two authors screened the titles, abstracts and full texts independently. Disagreements were resolved with a third author. The modified Newcastle-Ottawa Scale was used for quality assessment. Results: Ninety-six studies were identified, with 69 of them rated to have a low risk of bias. In total, 33 unique instruments were described. Disease Count and weighted indices like Charlson Comorbidity Index were commonly used. Other approaches included pharmaceutical-based instruments. Disease Count was the common instrument used for measuring all three essential core outcomes of multimorbidity research: mortality, mental health and quality of life. There was a rise in the development of novel weighted indices by using prognostic models. The data obtained for measuring multimorbidity were from sources including medical records, patient self-reports and large administrative databases. Conclusions: We listed the details of 33 instruments for measuring the level of multimorbidity as a resource for investigators interested in the measurement of multimorbidity for its association with or prediction of a specific outcome.
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2020-041219
Rights: © 2021 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
Fulltext Permission: open
Fulltext Availability: With Fulltext
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