Mapping the behaviour change techniques used in patient-centred interventions for people with multimorbidity: a scoping review

Ageing populations and the increase in long-term conditions have contributed to a rise in the number of people living with multimorbidity (defined as the coexistence of two or more chronic conditions in the same individual), who often experience difficulties related to polypharmacy, treatment burden, competing priorities and poor coordination of care. Self-management education programs are increasingly included as an essential component of interventions to improve outcomes in this population. However, understanding how interventions support self-management in patients with multimorbidity is paramount. Recent developments in the design of health behaviour interventions have highlighted the importance of classifying intervention components (behaviour change techniques (BCT) and mapping these intervention components on to mechanisms of change.
This scoping review will focus on mapping the literature and identifying BCTs used in interventions that primarily target health behaviours and include educational or self- management elements in relation to people living with multimorbidity.

The scoping review process will be guided by the framework for conducting scoping reviews developed by the Joanna Briggs Institute (Peters et al., 2015). We will search electronic databases, the Cochrane Database of Systematic Reviews, clinical registries and grey literature for RCTs of interventions targeting health-related behaviours in people with multimorbidity published between 1990-2019. Patient-centred interventions that include patient education and/or self-management will be included. Two researchers will screen the studies retrieved by the search and code the BCTs present in the studies selected.

The interventions will be clustered by type, target behaviour/s and combinations of chronic conditions they address. A breakdown of the frequency and specific combinations of BCTs used across trials and for each targeted behaviour will be presented. A narrative synthesis will highlight important aspects of the studies included. We anticipate that the results will be available in February 2020.



The findings of this scoping review will help inform the development of a novel intervention for people with multimorbidity.