TY - JOUR
T1 - Core outcome sets for trials of interventions to prevent and to treat multimorbidity in adults in low and middle-income countries
T2 - The COSMOS study
AU - Vidyasagaran, Aishwarya Lakshmi
AU - Ayesha, Rubab
AU - Boehnke, Jan R.
AU - Kirkham, Jamie
AU - Rose, Louise
AU - Hurst, John R.
AU - Miranda, Juan Jaime
AU - Rana, Rusham Zahra
AU - Vedanthan, Rajesh
AU - Faisal, Mehreen Riaz
AU - Afaq, Saima
AU - Agarwal, Gina
AU - Aguilar-Salinas, Carlos Alberto
AU - Akinroye, Kingsley
AU - Akinyemi, Rufus Olusola
AU - Ali, Syed Rahmat
AU - Aman, Rabeea
AU - Anza-Ramirez, Cecilia
AU - Appuhamy, Koralagamage Kavindu
AU - Baldew, Se Sergio
AU - Barbui, Corrado
AU - Batista, Sandro Rogerio Rodrigues
AU - Caamaño, María Del Carmen
AU - Chowdhury, Asiful Haidar
AU - De Siqueira-Filha, Noemia Teixeira
AU - Del Castillo Fernández, Darwin
AU - Downey, Laura
AU - Flores-Flores, Oscar
AU - García, Olga P.
AU - García-Ulloa, Ana Cristina
AU - Holt, Richard I.G.
AU - Huque, Rumana
AU - Kabukye, Johnblack K.
AU - Kanan, Sushama
AU - Khalid, Humaira
AU - Koly, Kamrun Nahar
AU - Kwashie, Joseph Senyo
AU - Levitt, Naomi S.
AU - Lopez-Jaramillo, Patricio
AU - Mohan, Sailesh
AU - Muliyala, Krishna Prasad
AU - Naz, Qirat
AU - Odili, Augustine Nonso
AU - Oyeyemi, Adewale L.
AU - Pacheco-Barrios, Niels Victor
AU - Praveen, Devarsetty
AU - Purgato, Marianna
AU - Ronquillo, Dolores
AU - Siddiqi, Kamran
AU - Singh, Rakesh
AU - Tran, Phuong Bich
AU - Tufail, Pervaiz
AU - Uphoff, Eleonora P.
AU - Van Olmen, Josefien
AU - Verhey, Ruth
AU - Wright, Judy M.
AU - Zafra-Tanaka, Jessica Hanae
AU - Zavala, Gerardo A.
AU - Zhao, Yang William
AU - Siddiqi, Najma
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.
PY - 2024/8/19
Y1 - 2024/8/19
N2 - Introduction The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. Core outcome sets (COS) appropriate for the study of multimorbidity in LMICs do not presently exist. These are required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at preventing and treating multimorbidity in adults in LMICs. Methods To generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals and policymakers) with representation from 33 countries. Consensus meetings were used to reach agreement on the two final COS. Registration: https://www.comet-initiative.org/Studies/Details/1580. Results The systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention and 6 treatment outcomes were added from Delphi round 1. Delphi round 2 surveys were completed by 95 of 132 round 1 participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) adverse events, (2) development of new comorbidity, (3) health risk behaviour and (4) quality of life; and four for the treatment COS: (1) adherence to treatment, (2) adverse events, (3) out-of-pocket expenditure and (4) quality of life. Conclusion Following established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to adults in LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs. PROSPERO registration number CRD42020197293.
AB - Introduction The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. Core outcome sets (COS) appropriate for the study of multimorbidity in LMICs do not presently exist. These are required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at preventing and treating multimorbidity in adults in LMICs. Methods To generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals and policymakers) with representation from 33 countries. Consensus meetings were used to reach agreement on the two final COS. Registration: https://www.comet-initiative.org/Studies/Details/1580. Results The systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention and 6 treatment outcomes were added from Delphi round 1. Delphi round 2 surveys were completed by 95 of 132 round 1 participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) adverse events, (2) development of new comorbidity, (3) health risk behaviour and (4) quality of life; and four for the treatment COS: (1) adherence to treatment, (2) adverse events, (3) out-of-pocket expenditure and (4) quality of life. Conclusion Following established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to adults in LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs. PROSPERO registration number CRD42020197293.
KW - Other study design
KW - Prevention strategies
KW - Treatment
UR - https://www.scopus.com/pages/publications/85206291937
U2 - 10.1136/bmjgh-2024-015120
DO - 10.1136/bmjgh-2024-015120
M3 - Artículo
AN - SCOPUS:85206291937
SN - 2059-7908
VL - 9
JO - BMJ Global Health
JF - BMJ Global Health
IS - 8
M1 - e015120
ER -