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Specific Measures of Quality of Life in Patients with Multimorbidity in Primary Healthcare: A Systematic Review on Patient-Reported Outcome Measures’ Adequacy of Measurement

Authors Møller A, Bissenbakker KH, Arreskov AB, Brodersen J

Received 8 August 2019

Accepted for publication 27 November 2019

Published 8 January 2020 Volume 2020:11 Pages 1—10


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Robert Howland

Anne Møller, Kristine Henderson Bissenbakker, Anne Beiter Arreskov, John Brodersen

Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

Correspondence: Anne Møller Øster Farimagsgade 5, København DK-1353, Denmark
Tel +45 35327171

Purpose: The aim of this study is to search systematically for Patient Reported Outcome Measures (PROMs) used among patients with multimorbidity. Furthermore, the aim is to evaluate the adequacy and validity of the PROMs identified.
Design and setting: This systematic review follows the PRISMA guidelines. To assess the adequacy and validity of the identified PROMs the COSMIN Risk of Bias Checklist is used, more specifically a validation of the development, content validity, structural validity, and internal consistency of the PROMs.
Results: Four PROMs were identified in the primary search, and one was found from references. The sixth PROM was published after the primary search. None of the identified PROMs were aimed specifically at measuring the quality of life in patients with multimorbidity. According to the checklist, the development process and content validity were rated “adequate” in only one measure and “invalid”/“doubtful”/“inadequate” in the rest of the measures. The structural validity of the measures was rated “adequate” in four measures and “very good” in one. Regarding the internal consistency, two measures were rated doubtful and three “very good”. None of the six PROMs reported analyses about invariant measurement. The COSMIN Risk of Bias Checklist proved easy to use; however, there are some concerns in the rating of bias, that are discussed further.
Conclusion: All six PROMs developed for patients with multimorbidity identified possessed inadequacy in their measurement properties. Therefore, the aim for the future is to develop a valid and adequate measure of the quality of life among patients with multimorbidity.

Keywords: comorbidity, burden of treatment, burden of disease, validity, psychometric properties

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