Table 2.
Description of included studies.
| References | Intervention | Change in care delivery | Process goal | Target patients | Setting | Theoritical framework |
|---|---|---|---|---|---|---|
| Fortin et al. (7) | Multifaceted intervention including nurse interview and, consultations with other professionals and individualized care plan. | Professionals were added to existing family medicine teams | To enhance patient self-management | 3 or more chronic conditions | 7 family medicine groups (FMGs) in Quebec, Canada | Patient Centered Clinical Method (17), Chronic Care Model (16), and Self-management support (18) |
| Stewart et al. (9) | Multifaceted patient-centered care including a nurse interview at home, a team meeting, a care plan and nurse follow-up | Professionals were added and the team meeting was added | To improve patient engagement in their care and to reduce emergency room visits | 3 or more chronic conditions | 9 team-based family practices familiar with the intervention in Toronto, Ontario, Canada | Patient Centered Clinical Method (17), Chronic Care Model (16), and Self-management support (18) |
| Salisbury et al. (6) | Two appointments with a nurse and a named responsible physician, a medication review by a pharmacist, and a collaborative health plan with the patient | Replacing disease-focused reviews of each health condition by a comprehensive 3D multidisciplinary review | To improve continuity, coordination, and efficiency of care | Patients with at least 3 types of chronic conditions | 33 practices in England and Scotland | Patient Centered Clinical Method (17), and Chronic Care Model (16) |
| O'Toole et al. (12) | Professionally-led 6-week group self-management support program | Introducing educational and goal-setting components that included participant interaction and discussion | Self-management support aimed to have a specific focus on function and issues relevant to multimorbidity | 2 or more chronic conditions | 8 primary care teams in Eastern Ireland | Self-management support (18) |
| Kari et al. (13) | At-home patient interviews, an interprofessional team meetings (nurse, pharmacist and genral practitionner) to create a care plan | To include in-depth clinical medication and health reviews which are not present within the existing health system | To encourage patient active role in collaborative goal setting and empower them to live well with long-term conditions | Multimorbid patients with 7 or more prescribed medicines | Primary care settings in Tornio, Finland | People Centered Care Model (10), and Chronic Care Model (16) |
| Verdoorn et al. (14) | Clinical medication reviews (CMRs) with the availability of all clinical data and an extensive patient interview | A CMR review focused on personal goals which is not offered to all patients in usual care | Building on patients' health-related goals and preferences | Community-living multimorbid patients with 7 or more long-term medications | 35 community pharmacies in the Netherlands | Patient Centered Approach in Clinical Medication Review (8) |