Abstract
Introduction: Multimorbidity is increasingly important due to its high disease burden, prevalence and related high healthcare utilisation. For patients, there is also a high financial burden due to direct and indirect costs arising from their multimorbidity. It is unclear how this financial burden affects patients. This study aims to synthesise qualitative evidence exploring the experience of financial burden from the perspective of patients with multimorbidity. Methods: The review will be reported using the ENTREQ guidelines. A systematic search of Lilacs, PubMed, CINAHL, EMBASE, PsycINFO, and Applied Social Sciences Index and Abstracts will be conducted using a predefined search strategy. A search of fourteen pre-specified websites will be conducted for grey literature. Forward and backward citation checking of included studies will be conducted also. Studies will be included if they contain primary qualitative research and reference the experience of financial burden from the perspective of adult (≥ 18 years) community dwelling patients with multimorbidity. Studies from any country and in any language will be included. Titles and abstracts of search results will be screened; if a study appears relevant, then full-texts will be screened for eligibility. Study characteristics of included articles will be extracted. Study quality will be evaluated using the critical appraisal skills programme (CASP) checklist for qualitative research. These three processes will be carried out by two reviewers independently. Thematic-synthesis will be used to analyse data. This will be carried out by one reviewer and cross-checked by a second reviewer. The GRADE CERQual approach will be used to assess the overall confidence in the evidence. Discussion: This review will identify evidence on the experiences of financial burden for patients with multimorbidity and forms part of a project to support consideration of financial burden for patients in the development of clinical guidelines in Ireland. PROSPERO registration number:CRD42019135284.
Highlights
Multimorbidity is increasingly important due to its high disease burden, prevalence and related high healthcare utilisation
Multimorbidity is of increasing concern due to the high disease burden and the related high rates of healthcare utilisation
The review will add to the knowledge base of how financial burden affects patients with multimorbidity as well as informing potential policy and practice interventions for patients with multimorbidity
Summary
Multimorbidity is increasingly important due to its high disease burden, prevalence and related high healthcare utilisation. The estimated prevalence of multimorbidity in the general population ranges from 13% to 72%2 These variations are largely accounted for by differences in settings and age groups across prevalence studies. Healthcare systems internationally are primarily single disease focused[4] This single disease focus is reflected in clinical guidelines, which primarily treat diseases in isolation and rarely account for patients with multimorbidity. This creates a significant treatment burden[4] which has several consequences for patients with multimorbidity, including a financial burden. The authors state that variations in estimated prevalence of multimorbidity are due to differences in settings and age groups This is true but it is due to differences in methods of measurement.
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