Integrated Care Approaches for Multimorbid Heart Failure and Cardiorenal Metabolic Syndrome: A Scoping Review

Introduction: Heart failure (HF) is frequently associated with multiple long-term conditions, including cardiorenal metabolic (CaReMe) syndrome, increasing clinical complexity and care burden. Traditional disease specific pathways may not sufficiently address the needs of this population. Integrated, multidisciplinary models of care are increasingly advocated to support coordinated, person-centred management. This scoping review explores existing integrated care models for adults with multimorbid HF and CaReMe syndrome, with relevance to cardiac nursing practice and service delivery. Methods: A systematic search of MEDLINE, PubMed, CINAHL, the Cochrane Library, and grey literature was undertaken for primary research published between 2014 and 2025. Eligible studies described integrated, multispecialty, or multidisciplinary team (MDT) models of care for adults with HF and coexisting cardiorenal or metabolic conditions. The review followed PRISMA-ScR guidance, with data extraction informed by Joanna Briggs Institute and Cochrane methodologies. Results: Five studies from upper-middle and high-income countries met inclusion criteria. All reported MDT led integrated care involving collaboration across cardiology, renal, diabetes, nursing, and allied health services. Models were mapped using the Cochrane Effective Practice and Organisation of Care framework. Reported outcomes included reduced hospital admissions, improved treatment adherence, enhanced professional collaboration, and increased patient engagement. Variability in outcome measures and limited evaluation of governance, digital infrastructure, and cost-effectiveness were identified. Conclusions: Integrated care models show potential to improve coordination and patient-centred outcomes for people living with multimorbid HF and CaReMe syndrome. Further research is needed to support sustainable implementation, with a focus on nursing leadership, patient co-design, and standardised outcome measures.