Rookes, TA, Nimmons, D, Frost, R, Armstrong, M, Davies, L, Ross, J, Hopkins, J, Mistry, M, Taylor, S and Walters, K (2024) Effectiveness of complex behaviour change interventions tested in randomised controlled trials for people with multiple long-term conditions (M-LTCs): systematic review with meta-analysis. BMJ open, 14 (6).

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Abstract

The prevalence of multiple long-term conditions (M-LTCs) increases as adults age and impacts quality of life and health outcomes. To help people manage these conditions, complex behaviour change interventions are used, often based on research conducted in those with single LTCs. However, the needs of those with M-LTCs can differ due to complex health decision-making and engagement with multiple health and care teams. The aim of this review is to identify whether current interventions are effective for people living with M-LTCs, and which outcomes are most appropriate to detect this change. Five databases (MEDLINE, Embase, PsycINFO, CINAHL and Web of Science) were systematically searched, between January 1999 and January 2022, to identify randomised controlled trials evaluating effectiveness of behaviour change interventions in people with M-LTCs. Intervention characteristics, intervention effectiveness and outcome measures were meta-analysed and narratively synthesised. 53 eligible articles were included. Emotional well-being and psychological distress (depression and anxiety) outcomes were most amenable to change (emotional well-being: standardised mean difference (SMD) 0.31 (95% CI 0.04 to 0.58); depression psychological distress: SMD -0.45 (95% CI -0.73 to -0.16); anxiety psychological distress: SMD -0.14 (95% CI -0.28 to 0.00)), particularly for interventions with a collaborative care approach. Interventions targeting those with a physical and mental health condition and those with cognitive and/or behavioural activation approach saw larger reductions in psychological distress outcomes. Interventions that lasted for longer than 6 months significantly improved the widest variety of outcomes. Complex interventions can be successfully delivered to those with M-LTCs. These are most effective at reducing psychological distress in those with physical and mental LTCs. Further research is needed to identify the effective components of interventions for people with two or more physical LTCs and which outcome is most appropriate for detecting this change.

Item Type:	Article
Uncontrolled Keywords:	Humans; Behavior Therapy; Quality of Life; Randomized Controlled Trials as Topic; Multiple Chronic Conditions; Aging; Meta-Analysis; PUBLIC HEALTH; Patient Reported Outcome Measures; Primary Care; Systematic Review; Humans; Randomized Controlled Trials as Topic; Behavior Therapy; Quality of Life; Multiple Chronic Conditions; 1103 Clinical Sciences; 1117 Public Health and Health Services; 1199 Other Medical and Health Sciences
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Public Health Institute
Publisher:	BMJ Publishing Group
SWORD Depositor:	A Symplectic
Date Deposited:	03 Jul 2024 09:54
Last Modified:	03 Jul 2024 10:00
DOI or ID number:	10.1136/bmjopen-2023-081104
URI:	https://researchonline.ljmu.ac.uk/id/eprint/23686

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