The effectiveness of interventions to achieve co-ordinated multidisciplinary care and reduce hospital use for people with chronic diseases: Study protocol for a systematic review of reviews

Background: The burden of chronic disease on patients and the health service is growing. Current health policy emphasises the need for services which provide integrated and co-ordinated care for patients with chronic diseases, but there is uncertainty about which integrated care interventions and service models may be most effective. This review of reviews aims to synthesise the available evidence about the effectiveness of such interventions and service models in terms of patient experience of health and social care, the use of hospital and other health resources, and the associated costs. Methods/Design: We will search MEDLINE, Embase, ASSIA, PsycINFO, HMIC, CINAHL, Cochrane Library (including HTA Database, DARE and Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP, and Health Economic Evaluations databases for English language systematic reviews and meta-analyses published since 2000 that have evaluated the effectiveness of integrated care interventions for patients with chronic diseases. Interventions must deliver care that crosses the boundary between at least two health and/or social care settings. Outcomes of interest are healthcare resource use, patient quality of life/satisfaction, costs, and care co-ordination. Data from eligible reviews will be extracted by two independent reviewers and will include study details, the design, delivery and co-ordination of interventions, and methodological quality. Evidence synthesis will focus on a narrative overview of interventions and their effectiveness. Discussion: The review aims to summarise the evidence base about the effectiveness of integrated care interventions and service models and describe how interventions have been organised, co-ordinated, and delivered. The findings have the potential to impact on the commissioning of health and social care services in the UK which aim to provide integrated and co-ordinated care for patients with chronic disease and multimorbidity. Systematic review registration: PROSPERO CRD42015016458. © 2015 Damery et al.; licensee BioMed Central.