Mapping of primary care interventions targeting community-dwelling older adults with chronic multimorbidity: a scoping review

Multimorbidity is increasing globally and poses significant challenges for individuals and health systems. Disease-specific models of care often fail to address the complex and overlapping needs of older adults with multiple chronic conditions, contributing to fragmented services and treatment burden. This scoping review aimed to identify gaps in the knowledge base related to interventions targeting community-dwelling older adults with chronic multimorbidity in primary care settings. A comprehensive search of five databases identified peer-reviewed studies describing interventions targeting older adults aged 65 years and above with multimorbidity. Titles, abstracts, and full texts were screened by at least two independent reviewers. Reported facilitators and barriers to implementation were analysed using the Consolidated Framework for Implementation Research (CFIR). Twenty-three studies describing 21 interventions were included, most published from 2020 onwards. Care was the dominant intervention focus, often combined with rehabilitation, treatment, or prevention, and many interventions incorporated digital technologies to support self-management and care coordination. Implementation factors reflected differing perspectives: older adults emphasised comprehensibility, relational continuity, and alignment with everyday routines, whereas health professionals highlighted organisational fit, workload, and care coordination. Overall, interventions reflect a care-oriented and increasingly technology-enabled approach to multimorbidity management. However, important gaps remain in preventive and palliative strategies and in system-level integration across sectors. The review has been registered in OSF ( https://osf.io/mxjfg/overview ).

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Publication Details

Journal
Journal of Public Health
Published
2026-08-03
DOI
https://doi.org/10.1007/s10389-026-02868-z
Primary Topic
Chronic Disease Management Strategies
Type
article
Field-Weighted Citation Impact
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article

Mapping of primary care interventions targeting community-dwelling older adults with chronic multimorbidity: a scoping review

Anne-Marie Fiala Carlsen, Allan Riis, Julie Dalgaard Guldager, Jacob Uth et al.
Journal of Public Health
Chronic Disease Management Strategies
article

Mapping of primary care interventions targeting community-dwelling older adults with chronic multimorbidity: a scoping review

Anne-Marie Fiala Carlsen, Allan Riis, Julie Dalgaard Guldager, Jacob Uth, Vibeke Stenov, Christina Jessen-Winge, Jacob Østergaard Madsen, Palle Larsen
article en

Abstract

Multimorbidity is increasing globally and poses significant challenges for individuals and health systems. Disease-specific models of care often fail to address the complex and overlapping needs of older adults with multiple chronic conditions, contributing to fragmented services and treatment burden. This scoping review aimed to identify gaps in the knowledge base related to interventions targeting community-dwelling older adults with chronic multimorbidity in primary care settings. A comprehensive search of five databases identified peer-reviewed studies describing interventions targeting older adults aged 65 years and above with multimorbidity. Titles, abstracts, and full texts were screened by at least two independent reviewers. Reported facilitators and barriers to implementation were analysed using the Consolidated Framework for Implementation Research (CFIR). Twenty-three studies describing 21 interventions were included, most published from 2020 onwards. Care was the dominant intervention focus, often combined with rehabilitation, treatment, or prevention, and many interventions incorporated digital technologies to support self-management and care coordination. Implementation factors reflected differing perspectives: older adults emphasised comprehensibility, relational continuity, and alignment with everyday routines, whereas health professionals highlighted organisational fit, workload, and care coordination. Overall, interventions reflect a care-oriented and increasingly technology-enabled approach to multimorbidity management. However, important gaps remain in preventive and palliative strategies and in system-level integration across sectors. The review has been registered in OSF ( https://osf.io/mxjfg/overview ).

Journal of Public Health
University College Lillebaelt (DK), University College South Denmark (DK), University College of Northern Denmark (DK), University College Copenhagen (DK), University College Absalon (DK), VIA University College (DK), Aalborg University (DK)
Openalex Percentile: Top 9%
Chronic Disease Management Strategies
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