BMJ Global Health (Aug 2024)
Core outcome sets for trials of interventions to prevent and to treat multimorbidity in adults in low and middle-income countries: the COSMOS study
- ,
- Najma Siddiqi,
- Josefien van Olmen,
- Meena Daivadanam,
- Naveed Ahmed,
- Abdul Kuddus,
- John R Hurst,
- Rumana Huque,
- Bruno P Nunes,
- Devarsetty Praveen,
- Rajesh Vedanthan,
- Louise Rose,
- Naomi S Levitt,
- Gina Agarwal,
- Sailesh Mohan,
- Adewale L Oyeyemi,
- Patricio Lopez-Jaramillo,
- Marianna Purgato,
- Rachel Churchill,
- Corrado Barbui,
- Kamran Siddiqi,
- Sanjib Kumar Sharma,
- Judy M Wright,
- Helal Uddin Ahmed,
- Lijing L Yan,
- Jamie Kirkham,
- Laura Downey,
- Phuong Bich Tran,
- Elizabeth Shayo,
- Ana Cristina García-Ulloa,
- Carlos Alberto Aguilar-Salinas,
- Gerardo A Zavala,
- Faiza Aslam,
- Cecilia Anza-Ramirez,
- Anthony Danso-Appiah,
- Khaleda Islam,
- Abdou K Sillah,
- Saidur R Mashreky,
- Asiful Haidar Chowdhury,
- Ram Krishna Chandyo,
- Jessica Hanae Zafra-Tanaka,
- Rakesh Singh,
- Juan Jaime Miranda,
- Arun Kumar Sharma,
- Saima Afaq,
- Kamrun Nahar Koly,
- Ruth Verhey,
- Sushama Kanan,
- Rusham Zahra Rana,
- Oscar Flores-Flores,
- Rufus Olusola Akinyemi,
- Job van Boven,
- Santa Kumar Das,
- Rubab Ayesha,
- Jan R Boehnke,
- Aishwarya Lakshmi Vidyasagaran,
- Mehreen Riaz Faisal,
- Kingsley Akinroye,
- Syed Rahmat Ali,
- Rabeea Aman,
- Koralagamage Kavindu Appuhamy,
- Se-Sergio Baldew,
- Sandro Rogerio Rodrigues Batista,
- María del Carmen Caamaño,
- Noemia Teixeira de Siqueira-Filha,
- Darwin Del Castillo Fernández,
- Olga P García,
- Richard IG Holt,
- Johnblack K Kabukye,
- Humaira Khalid,
- Joseph Senyo Kwashie,
- Krishna Prasad Muliyala,
- Qirat Naz,
- Augustine Nonso Odili,
- Niels Victor Pacheco-Barrios,
- Dolores Ronquillo,
- Pervaiz Tufail,
- Eleonora P Uphoff,
- Yang William Zhao,
- Jibril Abdulmalik,
- Anoshmita Adhikary,
- Isaac Kwaku Adu,
- Christel Antonius-Smits,
- Anas Ashraful,
- Camilla Cadorin,
- Alyssa Chase,
- Daniella Eiloof,
- Tonatiuh Barrientos Gutierrez,
- Najma Hayat,
- Victoria Cavero Huapaya,
- Daniel Mograbi,
- Anum Naz,
- Zara Nisar,
- Adesola Odole,
- Obehi H Okojie,
- Abdrahamane Ouedraogo,
- Claudia Bambs Sandoval,
- Alejandro Zevallos-Morales
Affiliations
- Najma Siddiqi
- Department of Health Sciences, University of York, York, UK
- Josefien van Olmen
- Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium
- Meena Daivadanam
- Naveed Ahmed
- Abdul Kuddus
- John R Hurst
- UCL Respiratory, University College London, London, UK
- Rumana Huque
- Research and development, ARK Foundation, Dhaka, Bangladesh
- Bruno P Nunes
- Devarsetty Praveen
- The George Institute for Global Health India, Hyderabad, India
- Rajesh Vedanthan
- Section for Global Health, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
- Louise Rose
- Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
- Naomi S Levitt
- Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Gina Agarwal
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Sailesh Mohan
- Public Health Foundation of India, New Delhi, India
- Adewale L Oyeyemi
- College of Health Solutions, Arizona State University, Tempe, Arizona, USA
- Patricio Lopez-Jaramillo
- Masira Research Institute, Universidad de Santander, Bucaramanga, Colombia
- Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Rachel Churchill
- Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
- Sanjib Kumar Sharma
- Judy M Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Helal Uddin Ahmed
- Lijing L Yan
- Jamie Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester, UK
- Laura Downey
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Phuong Bich Tran
- Department of Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium
- Elizabeth Shayo
- Ana Cristina García-Ulloa
- Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
- Carlos Alberto Aguilar-Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Gerardo A Zavala
- Department of Health Sciences, University of York, York, UK
- Faiza Aslam
- Cecilia Anza-Ramirez
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Anthony Danso-Appiah
- Khaleda Islam
- Abdou K Sillah
- Saidur R Mashreky
- Asiful Haidar Chowdhury
- ARK Foundation, Dhaka, Bangladesh
- Ram Krishna Chandyo
- Jessica Hanae Zafra-Tanaka
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Rakesh Singh
- Department of Public Health, KIST Medical College, Kathmandu, Nepal
- Juan Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Arun Kumar Sharma
- Saima Afaq
- Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
- Ruth Verhey
- The Friendship Bench, Harare, Zimbabwe
- Sushama Kanan
- ARK Foundation, Dhaka, Bangladesh
- Rusham Zahra Rana
- The Healing Triad Pakistan, Lahore, Pakistan
- Oscar Flores-Flores
- Centro de Investigación del Envejecimiento (CIEN), Facultad de Medicina Humana, Universidad de San Martin de Porres, La Molina, Peru
- Rufus Olusola Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, University of Ibadan, Ibadan, Nigeria
- Job van Boven
- Santa Kumar Das
- Rubab Ayesha
- Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan
- Jan R Boehnke
- Department of Health Sciences, University of York, York, UK
- Aishwarya Lakshmi Vidyasagaran
- Department of Health Sciences, University of York, York, UK
- Mehreen Riaz Faisal
- Department of Health Sciences, University of York, York, UK
- Kingsley Akinroye
- Nigerian Heart Foundation, Lagos, Nigeria
- Syed Rahmat Ali
- Khyber Medical University, Peshawar, Pakistan
- Rabeea Aman
- Foundation University Islamabad, Islamabad, Pakistan
- Koralagamage Kavindu Appuhamy
- Department of Health Sciences, University of York, York, UK
- Se-Sergio Baldew
- Physical Therapy Department, Anton de Kom University of Suriname, Paramaribo, Suriname
- Sandro Rogerio Rodrigues Batista
- Family Medicine and Primary Health Care, Universidade Federal de Goiás, Goiania, Brazil
- María del Carmen Caamaño
- Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Queretaro, Mexico
- Noemia Teixeira de Siqueira-Filha
- Department of Health Sciences, University of York, York, UK
- Darwin Del Castillo Fernández
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Olga P García
- Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Queretaro, Mexico
- Richard IG Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- Johnblack K Kabukye
- Uganda Cancer Institute, Kampala, Uganda
- Humaira Khalid
- Pakistan Institute of Living and Learning, Karachi, Pakistan
- Joseph Senyo Kwashie
- Community and Family Aid Foundation, Accra, Ghana
- Krishna Prasad Muliyala
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
- Qirat Naz
- Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, Pakistan
- Augustine Nonso Odili
- Circulatory Health Research Laboratory, University of Abuja College of Health Sciences, Abuja, Nigeria
- Niels Victor Pacheco-Barrios
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Dolores Ronquillo
- Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Queretaro, Mexico
- Pervaiz Tufail
- Private Researcher, New York, NY, USA
- Eleonora P Uphoff
- Centre for Reviews and Dissemination, University of York, York, UK
- Yang William Zhao
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Jibril Abdulmalik
- Anoshmita Adhikary
- Isaac Kwaku Adu
- Christel Antonius-Smits
- Anas Ashraful
- Camilla Cadorin
- Alyssa Chase
- Daniella Eiloof
- Tonatiuh Barrientos Gutierrez
- Najma Hayat
- Victoria Cavero Huapaya
- Daniel Mograbi
- Anum Naz
- Zara Nisar
- Adesola Odole
- Obehi H Okojie
- Abdrahamane Ouedraogo
- Claudia Bambs Sandoval
- Alejandro Zevallos-Morales
- DOI
- https://doi.org/10.1136/bmjgh-2024-015120
- Journal volume & issue
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Vol. 9,
no. 8
Abstract
Introduction The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. Core outcome sets (COS) appropriate for the study of multimorbidity in LMICs do not presently exist. These are required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at preventing and treating multimorbidity in adults in LMICs.Methods To generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals and policymakers) with representation from 33 countries. Consensus meetings were used to reach agreement on the two final COS. Registration: https://www.comet-initiative.org/Studies/Details/1580.Results The systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention and 6 treatment outcomes were added from Delphi round 1. Delphi round 2 surveys were completed by 95 of 132 round 1 participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) adverse events, (2) development of new comorbidity, (3) health risk behaviour and (4) quality of life; and four for the treatment COS: (1) adherence to treatment, (2) adverse events, (3) out-of-pocket expenditure and (4) quality of life.Conclusion Following established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to adults in LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs.PROSPERO registration number CRD42020197293.
