• Angelo Barbato, Barbara D'Avanzo, Michela Cinquini, Andrea Veronica Fittipaldo, Alessandro Nobili, Laura Amato, Simona Vecchi, and Graziano Onder.
• Department of Health Policy, Laboratory for Quality Assessment of Care and Services, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
• J Eval Clin Pract. 2022 Jun 1; 28 (3): 371-381.

ObjectiveTo systematically review the evidence from randomized controlled trials comparing the effects of goal-oriented care against standard care for multimorbid adults.Data Sources/Study SettingThe literature presenting the results of randomized trials assessing the outcomes of goal-oriented care compared with usual care for adults with multimorbidity.Study DesignSystematic review and meta-analysis.Data Collection/Extraction MethodsWe searched the Cochrane Database of Systematic Reviews (CENTRAL), EMBASE, MEDLINE, CINHAL, trial registries such as ClinicalTrial.gov and World Health Organization International Clinical Trials Registry Platform (ICTRP), and the references of eligible trials and relevant reviews. Goal-oriented care was defined as an approach that engages patients, establishes personal goals, and sets targets for patients and clinicians to plan a course of action and measure outcome. We reviewed 228 trials, and 12 were included. We extracted outcome data on quality of life, hospital admission, patients' satisfaction, patient and caregiver burden. Risk of bias was assessed and certainty of evidence was evaluated using GRADE.Principal FindingsNo study was fully free of bias. No effect was found on quality of life (standardized mean difference [SMD]: 0.05; 95% CI: -0.05 to 0.16) and hospital admission (risk ratio [RR]: 0.87; 95% CI: 0.65 to 1.17). There was a very small effect for patients' satisfaction (SMD: 0.15; 95% CI: 0.00 to 0.29) and caregiver burden (SMD: -0.13; 95% CI: -0.26 to 0.00). Certainty of evidence was low for all outcomes.ConclusionsNo firm conclusions can be reached about the effects of goal-oriented care for multimorbid adults. Future research should overcome the shortcomings of trials assessed in this meta-analysis. Sound application of the indications for research of complex healthcare interventions is warranted.© 2022 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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