Scoping review of measures of treatment burden in patients with multimorbidity: advancements and current gaps

Mendoza-Quispe D.; Perez-Leon S.; Alarcon-Ruiz C.A.; Gaspar A.; Cuba-Fuentes M.S.; Zunt J.R.; Montori V.M.; Bazo-Alvarez J.C.; Miranda J.J. · Journal of Clinical Epidemiology (2023) · DOI: 10.1016/j.jclinepi.2023.05.013

Resumen

Objectives: To identify, assess, and summarize the measures to assess burden of treatment in patients with multimorbidity (BoT-MMs) and their measurement properties. Study Design and Setting: MEDLINE via PubMed was searched from inception until May 2021. Independent reviewers extracted data from studies in which BoT-MMs were developed, validated, or reported as used, including an assessment of their measurement properties (e.g., validity and reliability) using the COnsensus-based Standards for the selection of health Measurement INstruments. Results: Eight BoT-MMs were identified across 72 studies. Most studies were performed in English (68%), in high-income countries (90%), without noting urban-rural settings (90%). No BoT-MMs had both sufficient content validity and internal consistency; some measurement properties were either insufficient or uncertain (e.g., responsiveness). Other frequent limitations of BoT-MMs included absent recall time, presence of floor effects, and unclear rationale for categorizing and interpreting raw scores. Conclusion: The evidence needed for use of extant BoT-MMs in patients with multimorbidity remains insufficiently developed, including that of suitability for their development, measurement properties, interpretability of scores, and use in low-resource settings. This review summarizes this evidence and identifies issues needing attention for using BoT-MMs in research and clinical practice.

Instituciones: Universidad Peruana Cayetano Heredia; Universidad San Ignacio de Loyola