Mapping interventional components and behaviour change techniques used to promote self-management in people with multimorbidity: a scoping review.

Abstract Ageing populations and improved survival, have contributed to a rise in the number of people living with multimorbidity, raising issues related to polypharmacy, treatment burden, competing priorities and poor coordination of care. Self-management programs are increasingly included as an essential component of interventions to improve outcomes in this population. However, an overview of how interventions supporting self-management in patients with multimorbidity is missing. This scoping review focused on mapping the literature on patient-centered interventions for people living with multimorbidity that supports self-management. The process was guided by the framework for conducting scoping reviews developed by the Joanna Briggs Institute (JBI). We searched the Cochrane Database of Systematic Reviews, Joanna Briggs Library, MEDLINE, EMBASE, CINAHL, Scopus and Psychinfo, clinical registries, and grey literature for RCTs published between 1990-2019 describing interventions that supported self-management in people with multimorbidity. We included 72 studies that were found to be very heterogeneous when it comes to the population, delivery modes and modalities, intervention elements and facilitators. The results pointed to an extensive use of cognitive behavioural therapy as a basis for interventions, as well as behaviour change theories and chronic disease management frameworks. The most coded behaviour change techniques stemmed from the categories Social Support, Feedback and monitoring and Goals and Planning. To allow for implementation of effective interventions in clinical practice, improved reporting of intervention mechanisms in RCTs is warranted.