Tavares Sara, Reisberg Arad, Belsey David, Henley Ania, Downey Laura
Imperial College London, The George Institute Global Health, Scale Space, London, England.
Patient Experience Research Centre (PERC), Imperial College London, London, England.
PLoS One. 2025 Aug 1;20(8):e0328016. doi: 10.1371/journal.pone.0328016. eCollection 2025.
People living with multiple long-term conditions (MLTC) are reported to have poorer quality of life, worse health outcomes, and higher health-related expenses compared to those with singular chronic health conditions. Living with MLTC is associated with a higher risk of care that is duplicate or unnecessary. Understanding and monitoring the quality of care (QoC) for those with MLTC is imperative to ensure that individuals complex care needs are met, maximising health and wellbeing and minimising harm and social/economic burden. There is paucity on what QoC means in the context of MLTC, which is likely different than a mere amalgamation of quality indicators of each contributory condition. There is even less understanding on how QoC can be measured in a way that meets the specific care priorities of individuals with MLTC. The aim of this review is to systematically map and analyse evidence on what QoC means for those affected by MLTC and the content and processes of any existing QoC indicators in MLTC, developed with patient or caregivers.
We will systematically search for evidence following a Levac et al methodological scoping review process. All eligible studies published in English from 2000 onwards in the following databases will be included: MEDLINE, EMBASE, CINAHL, APA PsycINFO, Global Health and Health Management Information Consortium. Given expected study heterogeneity, a narrative synthesis is anticipated. Our Community Partner Advisory Group will assist in the identification and analysis of relevant evidence.
Current evidence shows variations in concepts and approaches when developing, implementing or validating QoC indicators, not always capturing patients' preferences nor the complex processes required in MLTC care. Clarifying concepts and synthesising evidence-based knowledge in this area will be the first step to inform the development of a project aiming to develop a set of patient-derived QoC indicators for use across multiple settings in the United Kingdom (UK) and beyond.
Available on Open Science Framework on https://osf.io/gjr84.
据报道，与患有单一慢性健康状况的人相比，患有多种长期疾病（MLTC）的人生活质量较差，健康结局更糟，医疗相关费用更高。患有MLTC会增加重复或不必要护理的风险。了解和监测MLTC患者的护理质量（QoC）对于确保满足个体复杂的护理需求、最大化健康和福祉以及最小化伤害和社会/经济负担至关重要。在MLTC背景下，QoC的含义尚缺乏相关研究，这可能不同于简单合并每种相关疾病的质量指标。对于如何以满足MLTC患者特定护理优先事项的方式衡量QoC，人们的了解甚至更少。本综述的目的是系统地梳理和分析关于QoC对受MLTC影响的人意味着什么以及MLTC中任何现有QoC指标的内容和过程的证据，这些指标是与患者或护理人员共同制定的。
我们将按照Levac等人的方法学范围综述流程系统地搜索证据。将纳入2000年起在以下数据库中以英文发表的所有符合条件的研究：MEDLINE、EMBASE、CINAHL、APA PsycINFO、全球健康和健康管理信息联盟。鉴于预期的研究异质性，预计将进行叙述性综合分析。我们的社区合作伙伴咨询小组将协助识别和分析相关证据。
当前证据表明，在制定、实施或验证QoC指标时，概念和方法存在差异，并不总是能捕捉到患者的偏好或MLTC护理所需的复杂过程。阐明该领域的概念并综合基于证据的知识将是为一个旨在开发一套患者衍生的QoC指标以供英国及其他地区多个环境使用的项目提供信息的第一步。
可在开放科学框架上获取，网址为https://osf.io/gjr84。
