Development of a core outcome set for multimorbidity trials in low/middle-income countries (COSMOS): study protocol.

Journal: BMJ open

Volume: 12

Issue: 2

Year of Publication: 2022

Affiliated Institutions:  School of Health Sciences, University of Dundee, Dundee, UK j.r.boehnke@dundee.ac.uk. Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan. Centre for Biostatistics, The University of Manchester, Manchester, UK. Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. Global Alliance for Chronic Diseases, London, UK. Centre for Reviews and Dissemination and Cochrane Common Mental Disorders, University of York, York, UK. Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad San Martin de Porres, Lima, Peru. UCL Respiratory, University College London, London, UK. Chronic Disease Initiative for Africa and Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa. Department of Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium. Department of Health Sciences, University of York, York, UK. Department of Population Health, NYU Grossman School of Medicine, New York University, New York, New York, USA. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. Centre for Reviews and Dissemination, University of York, York, UK.

Abstract summary 

'Multimorbidity' describes the presence of two or more long-term conditions, which can include communicable, non-communicable diseases, and mental disorders. The rising global burden from multimorbidity is well documented, but trial evidence for effective interventions in low-/middle-income countries (LMICs) is limited. Selection of appropriate outcomes is fundamental to trial design to ensure cross-study comparability, but there is currently no agreement on a core outcome set (COS) to include in trials investigating multimorbidity specifically in LMICs. Our aim is to develop international consensus on two COSs for trials of interventions to prevent and treat multimorbidity in LMIC settings.Following methods recommended by the Core Outcome Measures in Effectiveness Trials initiative, the development of these two COSs will occur in parallel in three stages: (1) generation of a long list of potential outcomes for inclusion; (2) two-round online Delphi surveys and (3) consensus meetings. First, to generate an initial list of outcomes, we will conduct a systematic review of multimorbidity intervention and prevention trials and interviews with people living with multimorbidity and their caregivers in LMICs. Outcomes will be classified using an outcome taxonomy. Two-round Delphi surveys will be used to elicit importance scores for these outcomes from people living with multimorbidity, caregivers, healthcare professionals, policy makers and researchers in LMICs. Finally, consensus meetings including all of these stakeholders will be held to agree outcomes for inclusion in the two COSs.The study has been approved by the Research Governance Committee of the Department of Health Sciences, University of York, UK (HSRGC/2020/409/D:COSMOS). Each participating country/research group will obtain local ethics board approval. Informed consent will be obtained from all participants. We will disseminate findings through peer-reviewed open access publications, and presentations at global conferences selected to reach a wide range of LMIC stakeholders.CRD42020197293.

Authors & Co-authors:  Boehnke Jan R JR Rana Rusham Zahra RZ Kirkham Jamie J JJ Rose Louise L Agarwal Gina G Barbui Corrado C Chase-Vilchez Alyssa A Churchill Rachel R Flores-Flores Oscar O Hurst John R JR Levitt Naomi N van Olmen Josefien J Purgato Marianna M Siddiqi Kamran K Uphoff Eleonora E Vedanthan Rajesh R Wright Judy J Wright Kath K Zavala Gerardo A GA Siddiqi Najma N

Study Outcome 

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Statistics
Citations :  Murray CJL, Barber RM, Foreman KJ, et al. . Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. The Lancet 2015;386:2145–91. 10.1016/S0140-6736(15)61340-X
Authors :  20
Identifiers
Doi : e051810
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Delphi Technique
Other Terms
clinical trials;protocols & guidelines;quality in health care;statistics & research methods
Study Design
Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
England