Health-related preferences of older patients with multimorbidity: an evidence map

González González AI, Schmucker C, Nothacker J, Motschall E, Nguyen TS, Brueckle M-S, Blom J, van den Akker M, Röttger K, Wegwarth O, Hoffmann T, et al. (2019)
BMJ Open 9(12): e034485.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
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DOI
Autor*in
González González, Ana IsabelUniBi; Schmucker, Christine; Nothacker, Julia; Motschall, Edith; Nguyen, Truc Sophia; Brueckle, Maria-Sophie; Blom, Jeanet; van den Akker, Marjan; Röttger, Kristian; Wegwarth, Odette; Hoffmann, Tammy; Straus, Sharon E
Alle
Einrichtung
Medizinische Fakultät OWL > AG 5 Allgemein- und Familienmedizin
Abstract / Bemerkung

**Objectives**
To systematically identify knowledge clusters and research gaps in the health-related preferences of older patients with multimorbidity by mapping current evidence.

**Design**
Evidence map (systematic review variant).

**Data sources**
MEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL and Science Citation Index/Social Science Citation Index/-Expanded from inception to April 2018.

**Study selection**
Studies reporting primary research on health-related preferences of older patients (mean age ≥60 years) with multimorbidity (≥2 chronic/acute conditions).

**Data extraction**
Two independent reviewers assessed studies for eligibility, extracted data and clustered the studies using MAXQDA-18 content analysis software.

**Results**
The 152 included studies (62% from North America, 28% from Europe) comprised 57 093 patients overall (range 9–9105). All used an observational design except for one interventional study: 63 (41%) were qualitative (59 cross-sectional, 4 longitudinal), 85 (57%) quantitative (63 cross-sectional, 22 longitudinal) and 3 (2%) used mixed methods. The setting was specialised care in 85 (56%) and primary care in 54 (36%) studies. We identified seven clusters of studies on preferences: end-of-life care (n=51, 34%), self-management (n=34, 22%), treatment (n=32, 21%), involvement in shared decision making (n=25, 17%), health outcome prioritisation/goal setting (n=19, 13%), healthcare service (n=12, 8%) and screening/diagnostic testing (n=1, 1%). Terminology (eg, preferences, views and perspectives) and concepts (eg, trade-offs, decision regret, goal setting) used to describe health-related preferences varied substantially between studies.

**Conclusion**
Our study provides the first evidence map on the preferences of older patients with multimorbidity. Included studies were mostly conducted in developed countries and covered a broad range of issues. Evidence on patient preferences concerning decision-making on screening and diagnostic testing was scarce. Differences in employed terminology, decision-making components and concepts, as well as the sparsity of intervention studies, are challenges for future research into evidence-based decision support seeking to elicit the preferences of older patients with multimorbidity and help them construct preferences.

**Trial registration number**
Open Science Framework (OSF): DOI 10.17605/OSF.IO/MCRWQ.

Erscheinungsjahr
2019
Zeitschriftentitel
BMJ Open
Band
9
Ausgabe
12
Art.-Nr.
e034485
ISSN
2044-6055
eISSN
2044-6055
Page URI
https://pub.uni-bielefeld.de/record/2986029

Zitieren

González González AI, Schmucker C, Nothacker J, et al. Health-related preferences of older patients with multimorbidity: an evidence map. BMJ Open. 2019;9(12): e034485.
González González, A. I., Schmucker, C., Nothacker, J., Motschall, E., Nguyen, T. S., Brueckle, M. - S., Blom, J., et al. (2019). Health-related preferences of older patients with multimorbidity: an evidence map. BMJ Open, 9(12), e034485. https://doi.org/10.1136/bmjopen-2019-034485
González González, Ana Isabel, Schmucker, Christine, Nothacker, Julia, Motschall, Edith, Nguyen, Truc Sophia, Brueckle, Maria-Sophie, Blom, Jeanet, et al. 2019. “Health-related preferences of older patients with multimorbidity: an evidence map”. BMJ Open 9 (12): e034485.
González González, A. I., Schmucker, C., Nothacker, J., Motschall, E., Nguyen, T. S., Brueckle, M. - S., Blom, J., van den Akker, M., Röttger, K., Wegwarth, O., et al. (2019). Health-related preferences of older patients with multimorbidity: an evidence map. BMJ Open 9:e034485.
González González, A.I., et al., 2019. Health-related preferences of older patients with multimorbidity: an evidence map. BMJ Open, 9(12): e034485.
A.I. González González, et al., “Health-related preferences of older patients with multimorbidity: an evidence map”, BMJ Open, vol. 9, 2019, : e034485.
González González, A.I., Schmucker, C., Nothacker, J., Motschall, E., Nguyen, T.S., Brueckle, M.-S., Blom, J., van den Akker, M., Röttger, K., Wegwarth, O., Hoffmann, T., Straus, S.E., Gerlach, F.M., Meerpohl, J.J., Muth, C.: Health-related preferences of older patients with multimorbidity: an evidence map. BMJ Open. 9, : e034485 (2019).
González González, Ana Isabel, Schmucker, Christine, Nothacker, Julia, Motschall, Edith, Nguyen, Truc Sophia, Brueckle, Maria-Sophie, Blom, Jeanet, van den Akker, Marjan, Röttger, Kristian, Wegwarth, Odette, Hoffmann, Tammy, Straus, Sharon E, Gerlach, Ferdinand M, Meerpohl, Joerg J, and Muth, Christiane. “Health-related preferences of older patients with multimorbidity: an evidence map”. BMJ Open 9.12 (2019): e034485.
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