title: Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: protocol for a systematic review alongside a realist review.
abstract: BACKGROUND
  The burden of chronic disease is a global phenomenon, particularly among people aged 65 years and older. More than half of older adults have more than one chronic disease and their care is not optimal. Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions.
  
  
  METHODS
  We will conduct a systematic review alongside a realist review to identify effective CDM tools that integrate one or more high-burden chronic diseases affecting older adults and to better understand for whom, under what circumstances, how and why they produce their outcomes. We will search MEDLINE, EMBASE, CINAHL, AgeLine and the Cochrane Library for experimental, quasi-experimental, observational and qualitative studies in any language investigating CDM tools that facilitate optimal disease management in one or more high-burden chronic diseases affecting adults aged ≥65 years. Study selection will involve calibration of reviewers to ensure reliability of screening and duplicate assessment of articles. Data abstraction and risk of bias assessment will also be performed independently. Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (meta-analysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies.
  
  
  BACKGROUND
  Ethics approval is not required for this study. We anticipate that our findings, pertaining to gaps in care across high-burden chronic diseases affecting seniors and highlighting specific areas that may require more research, will be of interest to a wide range of knowledge users and stakeholders. We will publish and present our findings widely, and also plan more active dissemination strategies such as workshops with our key stakeholders.
  
  
  BACKGROUND
  Our protocol is registered with PROSPERO (registration number CRD42014014489).
authors: Li KaShing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors: Monika
authors: M
authors: Kastner
authors: Li KaShing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
authors: Laure
authors: L
authors: Perrier
authors: Li KaShing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors: Jemila
authors: J
authors: Hamid
authors: Li KaShing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors: Andrea C
authors: AC
authors: Tricco
authors: Li KaShing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
authors: Roberta
authors: R
authors: Cardoso
authors: Department of Family Medicine, Women's College Hospital-University of Toronto, Toronto, Ontario, Canada.
authors: Noah M
authors: NM
authors: Ivers
authors: Regional Geriatric Program of Toronto; Sunnybrook Health Sciences, Geriatric Medicine, Toronto, Ontario, Canada.
authors: Barbara
authors: B
authors: Liu
authors: Division of Geriatric Medicine McMaster University, St Peter's Hospital/Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors: Sharon
authors: S
authors: Marr
authors: Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors: Jayna
authors: J
authors: Holroyd-Leduc
authors: Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK.
authors: Geoff
authors: G
authors: Wong
authors: Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada.
authors: Lisa
authors: L
authors: Graves
authors: Li KaShing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada Department of Medicine, University of Toronto, St Michael's Hospital, Toronto, Ontario, Canada.
authors: Sharon E
authors: SE
authors: Straus
mesh_terms: D000368:Aged; D002908:Chronic Disease; D019468:Disease Management; D006299:Health Services for the Aged; D006801:Humans; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D012107:Research Design; D000078202:Systematic Reviews as Topic; D057170:Translational Research, Biomedical
keywords: GENERAL MEDICINE (see Internal Medicine); INTERNAL MEDICINE
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