1. Core outcome sets for trials of interventions to prevent and to treat multimorbidity in adults in low and middle-income countries: the COSMOS study
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Najma Siddiqi, Josefien van Olmen, Meena Daivadanam, Naveed Ahmed, Abdul Kuddus, John R Hurst, Rumana Huque, Bruno P Nunes, Devarsetty Praveen, Rajesh Vedanthan, Louise Rose, Naomi S Levitt, Gina Agarwal, Sailesh Mohan, Adewale L Oyeyemi, Patricio Lopez-Jaramillo, Marianna Purgato, Rachel Churchill, Corrado Barbui, Kamran Siddiqi, Sanjib Kumar Sharma, Judy M Wright, Helal Uddin Ahmed, Lijing L Yan, Jamie Kirkham, Laura Downey, Phuong Bich Tran, Elizabeth Shayo, Ana Cristina García-Ulloa, Carlos Alberto Aguilar-Salinas, Gerardo A Zavala, Faiza Aslam, Cecilia Anza-Ramirez, Anthony Danso-Appiah, Khaleda Islam, Abdou K Sillah, Saidur R Mashreky, Asiful Haidar Chowdhury, Ram Krishna Chandyo, Jessica Hanae Zafra-Tanaka, Rakesh Singh, Juan Jaime Miranda, Arun Kumar Sharma, Saima Afaq, Kamrun Nahar Koly, Ruth Verhey, Sushama Kanan, Rusham Zahra Rana, Oscar Flores-Flores, Rufus Olusola Akinyemi, Job van Boven, Santa Kumar Das, Rubab Ayesha, Jan R Boehnke, Aishwarya Lakshmi Vidyasagaran, Mehreen Riaz Faisal, Kingsley Akinroye, Syed Rahmat Ali, Rabeea Aman, Koralagamage Kavindu Appuhamy, Se-Sergio Baldew, Sandro Rogerio Rodrigues Batista, María del Carmen Caamaño, Noemia Teixeira de Siqueira-Filha, Darwin Del Castillo Fernández, Olga P García, Richard IG Holt, Johnblack K Kabukye, Humaira Khalid, Joseph Senyo Kwashie, Krishna Prasad Muliyala, Qirat Naz, Augustine Nonso Odili, Niels Victor Pacheco-Barrios, Dolores Ronquillo, Pervaiz Tufail, Eleonora P Uphoff, Yang William Zhao, Jibril Abdulmalik, Anoshmita Adhikary, Isaac Kwaku Adu, Christel Antonius-Smits, Anas Ashraful, Camilla Cadorin, Alyssa Chase, Daniella Eiloof, Tonatiuh Barrientos Gutierrez, Najma Hayat, Victoria Cavero Huapaya, Daniel Mograbi, Anum Naz, Zara Nisar, Adesola Odole, Obehi H Okojie, Abdrahamane Ouedraogo, Claudia Bambs Sandoval, and Alejandro Zevallos-Morales
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Medicine (General) ,R5-920 ,Infectious and parasitic diseases ,RC109-216 - Abstract
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.
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- 2024
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