Multimorbidity was defined as an individual having two or more conditions, without a specific index condition being specified. Studies with a prospective, longitudinal design, whose main focus was multimorbidity in adults in primary care settings, were included. There were no restrictions on publication date or language of the full paper, but an abstract in English had to be available. As prospective cohort studies are the ‘gold standard’ for conducting such research, retrospective studies, cross-sectional study designs, evaluation studies, randomised controlled trials and intervention studies, studies that recruited only children aged <18 years, and those whose main focus was neither multimorbidity nor primary care data and/or settings were excluded.
How this fits in
Multimorbidity is becoming the norm, rather than the exception, in primary care, but evidence-based interventions are scarce. As knowledge of the effects of multimorbidity over time is a necessary precursor to developing effective interventions, a systematic review of prospective cohort studies of multimorbidity in primary care was carried out. Out of 996 articles identified, only six articles from five completed studies were found that were relevant; although the studies identified provide useful information, they also demonstrate significant gaps in knowledge. To plan future healthcare services and treatment guidelines for those with multimorbidity, a better understanding of the personal experience, treatment, and health service use, as well as the psychological, physical, and social factors that influence multimorbidity over time, is needed.