What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

Abstract

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis

“…Administrative data (11 studies) [ 11 , 55 , 57 , 58 , 62 , 64 , 65 , 76–78 ], self-report (15 studies) [ 19 , 34 , 59 , 61 , 63 , 67–72 , 74 , 75 , 80 , 82 ] and medical report (7 studies) [ 12 , 54 , 60 , 66 , 73 , 79 , 81 ] were the multimorbidity data sources reported. Among these, self-report was the most used; followed by administrative data and medical reports.…”

“…Our study was registered in PROSPERO (International Prospective Register of Systematic Reviews) (CRD42021229328). More details can be found in the systematic review protocol [ 19 ].…”

“…The risk of bias during the process of selection of studies was assessed using the Downs & Black Scale [ 46 ]. However, only the items related to observational studies [ 1–3 , 5–12 , 17 , 19 , 20 , 24 , 25 ] were applied [ 47 ]. Studies with scores higher than 70% were considered as having a low risk of bias [ 46 ].…”

Prevalence and Determinants of Medication Adherence in Patients with Multi-morbidities attending General Outpatient Clinics in Secondary Health Care Facilities in Kaduna State

“…2 However, multi-morbidity management is associated with increased likelihood of polypharmacy; increased prevalence of adverse effect of the prescribed medications, hospitalisation and mounting cost of healthcare. 8,30 Majority of the respondents from this study had low adherence. These findings are lower than that from a study in Ireland where low adherence was about 40%.…”

“…28,29 Therefore the findings from this study point to the fact these respondents are at an increased risk of the occurrence of adverse health outcomes such as disability, reduction in the quality of life especially when left uncontrolled, as well as a reduction in the life expectancy of the patients. 30 Adequate management of the various co-morbidities is hinged on primordial, primary and secondary preventive measures. Most of the cases require prolonged (sometimes lifelong) drug treatment to achieve the desired health outcomes.…”