Ethnic differences in the patterns, incidence and prevalence of multiple long-term conditions: a systematic review...

Multiple long-term conditions (MLTC) or multimorbidity is increasing among populations worldwide in the last decades. Less is known about the prevalence, incidence, socio-demographic patterning and combinations of long-term conditions among different ethnic groups globally. This systematic review protocol plans to review the current literature to understand the incidence, patterns, prevalence, and impact of MLTC in different ethnic populations.

This systematic review will include quantitative studies (cohort studies, cross-sectional, case-control, and baseline data from Randomised Control Trials) reporting on MLTC among adults across different ethnic groups in all settings (primary care, community or hospital). The following databases will be searched: Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, ASSIA and COCHRANE CENTRAL using a combination of search terms including MLTC or multimorbidity and ethnicity. The exposure of interest is ethnicity, and included studies will report on at least one of these outcomes by ethnicity or a proxy of it: 1. prevalence and incidence of MLTC; 2. MLTC types (combinations or patterns of conditions including physical-only, mental and physical and complex multimorbidity, which is three or more (3+) chronic conditions across 3+ body system), and 3. health related outcomes (healthcare utilisation and mortality). Two reviewers will screen potential articles by titles/abstracts and full texts independently. A synthesis without meta-analysis approach to comprehensively summarise the key attributes and findings reported from each included study will be employed initially. Meta-analysis will be conducted where data allow, to estimate the risk of MLTC in minority ethnic groups vs majority ethnicity.

Some studies suggest people from ethnic minority backgrounds have a greater burden of MLTC, yet they are usually underserved in health research. Synthesising primary studies that focus on MLTC and ethnicity in this review will provide a global overview of prevalence or incidence data and their reported health outcomes among diverse ethnic populations.