Mapping of primary care interventions targeting community-dwelling older adults with chronic multimorbidity: a scoping review
摘要
Multimorbidity is increasing globally and poses significant challenges for individuals and health systems. Disease-specific models of care often fail to address the complex and overlapping needs of older adults with multiple chronic conditions, contributing to fragmented services and treatment burden. This scoping review aimed to identify gaps in the knowledge base related to interventions targeting community-dwelling older adults with chronic multimorbidity in primary care settings.
Subject and methodsA comprehensive search of five databases identified peer-reviewed studies describing interventions targeting older adults aged 65 years and above with multimorbidity. Titles, abstracts, and full texts were screened by at least two independent reviewers. Reported facilitators and barriers to implementation were analysed using the Consolidated Framework for Implementation Research (CFIR).
ResultsTwenty-three studies describing 21 interventions were included, most published from 2020 onwards. Care was the dominant intervention focus, often combined with rehabilitation, treatment, or prevention, and many interventions incorporated digital technologies to support self-management and care coordination. Implementation factors reflected differing perspectives: older adults emphasised comprehensibility, relational continuity, and alignment with everyday routines, whereas health professionals highlighted organisational fit, workload, and care coordination.
ConclusionOverall, interventions reflect a care-oriented and increasingly technology-enabled approach to multimorbidity management. However, important gaps remain in preventive and palliative strategies and in system-level integration across sectors.
Review registrationThe review has been registered in OSF (https://osf.io/mxjfg/overview).