{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T19:23:21Z","timestamp":1774898601707,"version":"3.50.1"},"reference-count":44,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T00:00:00Z","timestamp":1700265600000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o Ci\u00eancia e Tecnologia","award":["CHRC (UIDP\/04923\/2020)"],"award-info":[{"award-number":["CHRC (UIDP\/04923\/2020)"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,10,12]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Health information systems represent an opportunity to improve the care provided to people with multimorbidity. There is a pressing need to assess their impact on clinical outcomes to validate this intervention. Our study will determine whether using a digital platform (Multimorbidity Management Health Information System, METHIS) to manage multimorbidity improves health-related quality of life (HR-QoL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A superiority, cluster randomised trial will be conducted at primary healthcare practices (1:1 allocation ratio). All public practices in the Lisbon and Tagus Valley (LVT) Region, Portugal, not involved in a previous pilot trial, will be eligible. At the participant level, eligible patients will be people with complex multimorbidity, aged 50 years or older, with access to an internet connection and a communication technology device. Participants who cannot sign\/read\/write and who do not have access to an email account will not be included in the study. The intervention combines a training programme and a customised information system (METHIS). Both are designed to help clinicians adopt a goal-oriented care model approach and to encourage patients and carers to play a more active role in autonomous healthcare. The primary outcome is HR-QoL, measured at 12 months with the physical component scale of the 12-item Short Form questionnaire (SF-12). Secondary outcomes will also be measured at 12 months and include mental health (mental component Scale SF-12, Hospital Anxiety and Depression Scale). We will also assess serious adverse events during the trial, including hospitalisation and emergency services. Finally, at 18 months, we will ask the general practitioners for any potentially missed diagnoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The Research and Ethics Committee (LVT Region) approved the trial protocol. Clinicians and patients will sign an informed consent. A data management officer will handle all data, and the publication of several scientific papers and presentations at relevant conferences\/workshops is envisaged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05593835\">NCT05593835<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-070044","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T22:00:13Z","timestamp":1700258413000},"page":"e070044","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Protocol for a cluster randomised trial of a goal-oriented care approach for multimorbidity patients supported by a digital platform"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct05593835","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05593835","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9367-5899","authenticated-orcid":false,"given":"Margarida","family":"Gil Conde","sequence":"first","affiliation":[{"name":"USF Jardins da Encarna\u00e7\u00e3o, ACeS Lisboa Central\/ Research and Ethics Committee, ARSLVT, Lisboa, Portugal"},{"name":"University Clinic of Family Medicine, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4976-2826","authenticated-orcid":false,"given":"Mariana","family":"Peyroteo","sequence":"additional","affiliation":[{"name":"UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal"},{"name":"Laborat\u00f3rio Associado de Sistemas Inteligentes, LASI, 4800-058 Guimar\u00e3es, Portugal"}]},{"given":"Ana","family":"Maria","sequence":"additional","affiliation":[{"name":"CHRC, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal"}]},{"given":"M\u00e9lanie Raimundo","family":"Maia","sequence":"additional","affiliation":[{"name":"UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal"},{"name":"Laborat\u00f3rio Associado de Sistemas Inteligentes, LASI, 4800-058 Guimar\u00e3es, Portugal"},{"name":"CHRC, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal"}]},{"given":"Jo\u00e3o","family":"Greg\u00f3rio","sequence":"additional","affiliation":[{"name":"CBIOS, Universidade Lus\u00f3fona de Humanidades e Tecnologias Escola de Ci\u00eancias e Tecnologias da Sa\u00fade, Lisboa, Portugal"}]},{"given":"Marilia Silva","family":"Paulo","sequence":"additional","affiliation":[{"name":"CHRC, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal"},{"name":"Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE"}]},{"given":"Marta","family":"Alves","sequence":"additional","affiliation":[{"name":"CEAUL, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal"}]},{"given":"Ana Lu\u00edsa","family":"Papoila","sequence":"additional","affiliation":[{"name":"CEAUL, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal"}]},{"given":"Lu\u00eds Velez","family":"Lap\u00e3o","sequence":"additional","affiliation":[{"name":"UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal"},{"name":"Laborat\u00f3rio Associado de Sistemas Inteligentes, LASI, 4800-058 Guimar\u00e3es, Portugal"},{"name":"WHO Collaborating Center on Health Workforce Policy and Planning, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal"}]},{"given":"Bruno","family":"Heleno","sequence":"additional","affiliation":[{"name":"CHRC, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, Lisboa, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2023,11,17]]},"reference":[{"key":"2025121300241887000_13.11.e070044.1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ejim.2015.02.020","article-title":"Time to face the challenge of Multimorbidity. 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