Effectiveness and Experiences of Self-Management Interventions in Adults With Multiple Long-Term Conditions: A Mixed...

Individuals who live with multiple long-term conditions (MLTCs) are more likely to experience poor quality of life and premature mortality. Supporting self-management is important in reducing the health burden experienced by this population. However, evidence remains limited regarding both the effect and lived experiences of self-management support interventions specifically designed for individuals with MLTCs.

This mixed-methods systematic review aimed to identify and summarise findings on the effectiveness and experiences of self-management support interventions for adults living with MLTCs.

MEDLINE, PsycINFO, CINAHL, Web of Science and Cochrane Library were searched from inception to July 2025. Eligible studies included adults aged 18 years or above with two or more long-term conditions. Quantitative, qualitative and mixed-method designs were included. Quantitative and qualitative findings were synthesised separately, with meta-integration used to integrate quantitative and qualitative evidence where appropriate. Study quality was assessed using validated appraisal tools appropriate to each study design.

Twenty-eight studies met the inclusion criteria. Quantitative evidence indicated modest improvements in specific self-management behaviours (health-directed behaviours, self-monitoring and skill acquisition). However, there was little to no effect of self-management support interventions for MLTCs on quality of life or psychological outcomes. In contrast, qualitative findings indicated perceived improvements in quality of life, mental health and self-management behaviours, and highlighted the influence of social factors, such as relationships and finances, on engagement in self-management interventions.

Although modest improvements were observed in specific self-management behaviours, there is little to no quantitative evidence that self-management interventions improve most outcomes for people with MLTCs, including quality of life and mental health. These effects remain uncertain due to mixed findings across qualitative and quantitative studies, as qualitative findings indicated benefits for quality of life and mental health. This emphasises the need for validated, MLTC-specific outcome measures in future research.