The content and processes of patient-derived quality of care indicators for people living with multiple long-term conditions (MLTC): a scoping review
Author(s)
Type
Journal Article
Abstract
Background: The growing prevalence of multiple long-term conditions (MLTC) poses a public health challenge. Existing quality of care (QoC) indicators are poorly suited to the needs of MLTC populations with limited clarity on how quality should be measured. This scoping review aimed to map QoC indicators for MLTC in primary care developed with patient and caregiver input, and to characterise the methods and extent of that involvement.
Methods: Scoping review following the six-stage framework by Arksey and O’Malley refined by Levac et al. Searches were conducted on six databases. Studies were included if adults with two or more chronic conditions were involved. Data were charted on indicator content (name, quality domain, data sources, measurement characteristics) and development processes (methodological approaches and stakeholders involved). Where indicators were not specified, qualitative findings were synthesised to identify QoC domains and mapped to the Donabedian model and Institute of Medicine quality domains. Community partners with lived experience of MLTC were involved.
Results: Twenty-five studies were included, 78 QoC indicators were identified and a further 33 quality domains were synthesised through thematic analysis. Quality was predominately measured through patient experience surveys rather than indicators. Studies articulated quality through care processes such as care coordination, shared decision.
Methods: Scoping review following the six-stage framework by Arksey and O’Malley refined by Levac et al. Searches were conducted on six databases. Studies were included if adults with two or more chronic conditions were involved. Data were charted on indicator content (name, quality domain, data sources, measurement characteristics) and development processes (methodological approaches and stakeholders involved). Where indicators were not specified, qualitative findings were synthesised to identify QoC domains and mapped to the Donabedian model and Institute of Medicine quality domains. Community partners with lived experience of MLTC were involved.
Results: Twenty-five studies were included, 78 QoC indicators were identified and a further 33 quality domains were synthesised through thematic analysis. Quality was predominately measured through patient experience surveys rather than indicators. Studies articulated quality through care processes such as care coordination, shared decision.
Date Issued
2026-06-01
Date Acceptance
2026-04-30
Citation
Journal of Multimorbidity and Comorbidity, 2026, 16
ISSN
2633-5565
Publisher
SAGE Publishing
Journal / Book Title
Journal of Multimorbidity and Comorbidity
Volume
16
Copyright Statement
© The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
License URL
Identifier
10.1177/26335565261451686
Subjects
multimorbidity
multiple long-term conditions (MLTC)
quality indicators
quality of care
patient involvement
scoping review
Publication Status
Published
Date Publish Online
2026-05-14