Multimorbid Heart failure (HF) and Cardiorenal Metabolic (CaReMe) Syndrome, exploring integrated models of care: A scoping review

Lavery, J ORCID: 0000-0003-4252-9909, Van Miert, C ORCID: 0000-0003-0287-9832, McCunnell, L, Hayes, J ORCID: 0000-0002-1770-4683, Higginbotham, K ORCID: 0000-0003-0795-7473 and Jones, I ORCID: 0000-0002-3081-0069 Multimorbid Heart failure (HF) and Cardiorenal Metabolic (CaReMe) Syndrome, exploring integrated models of care: A scoping review. Journal of Multimorbidity and Comorbidity. ISSN 2633-5565 (Accepted)

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Abstract

Background
Heart failure (HF) remains a global cause of morbidity and mortality and is increasingly complex to manage due to high prevalence of multimorbidity and coexisting cardiorenal and metabolic (CaReMe) syndrome. Individualised care through integrated service models can improve quality and maximise patient outcomes. This scoping review identifies and synthesises models of integrated care for multimorbid HF and CaReMe syndrome, analysing organisation, implementation, and reported outcome measures.
Methods
A systematic search was conducted in MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), COCHRANE library, and grey literature. Eligible studies included primary research published between 2014 and 2025 describing integrated, multispecialty, or multidisciplinary team (MDT) models of care for adults with multimorbid HF and CaReMe disease. The search followed PRISMA-ScR reporting standards and studies reviewed using standardised tools informed by Joanna Briggs Institute (JBI) and Cochrane Collaborations Tool methodologies.
Results:
Five studies were identified from upper-middle and high-income countries that incorporated MDT integrated care models. Models were mapped to the Effective Practice and Organisation of Care (EPOC) framework explaining key components of integrated care.
Positive outcomes included reduced hospitalisations, improved treatment adherence, enhanced collaborative processes, and patient engagement. Limited governance structures, variable outcome measures, gaps in financial and technological evaluations were also identified.
Conclusion:
Integrated care models for multimorbid HF and CaReMe syndrome demonstrate potential to enhance care coordination and quality of life. Evidence gaps persist regarding practical implementation, economic viability, and flexibility across healthcare settings. Future research should prioritise patient co-design, standardised outcomes, and shared decision-making frameworks.

Item Type:	Article
Uncontrolled Keywords:	cardiorenal metabolic syndrome; heart failure; integrated care; multimorbidity; scoping review
Subjects:	R Medicine > RT Nursing
Divisions:	Nursing and Advanced Practice
Publisher:	SAGE Publishing
Date of acceptance:	25 May 2026
Date Deposited:	23 Jun 2026 10:46
Last Modified:	23 Jun 2026 10:46
DOI or ID number:	10.1177/26335565261458448
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28884

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