Medical complexity in emergency and urgent care settings: a scoping review protocol

Introduction Considering the impact of non-medical factors (personal and social) on patients with multiple chronic conditions, the term ‘medical complexity’ is gaining traction as it encompasses both medical and non-medical aspects of patients’ medical needs. When primary care is not able to provide...

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Main Authors: Diane Lorenzetti, Tanvir C Turin, Sumedh Bele, Eddy Lang, Doreen Rabi, Naomi Popeski, Marie-Claire Uwamahoro, Conne Lategan, Kate Yakubets, Cassandra Chisholm
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e086984.full
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author Diane Lorenzetti
Tanvir C Turin
Sumedh Bele
Eddy Lang
Doreen Rabi
Naomi Popeski
Marie-Claire Uwamahoro
Conne Lategan
Kate Yakubets
Cassandra Chisholm
author_facet Diane Lorenzetti
Tanvir C Turin
Sumedh Bele
Eddy Lang
Doreen Rabi
Naomi Popeski
Marie-Claire Uwamahoro
Conne Lategan
Kate Yakubets
Cassandra Chisholm
author_sort Diane Lorenzetti
collection DOAJ
description Introduction Considering the impact of non-medical factors (personal and social) on patients with multiple chronic conditions, the term ‘medical complexity’ is gaining traction as it encompasses both medical and non-medical aspects of patients’ medical needs. When primary care is not able to provide timely care for chronic challenges or acute concerns, complex patients require care in emergency or urgent care settings. The concept of medical complexity is continually evolving, although without a universally accepted or standardised definition that determines if an adult patient is considered complex. Therefore, this scoping review aims to understand how medical complexity is defined, identify its defining attributes and examine its use in clinical care research. We also aim to consolidate and evaluate the evidence to suggest a more comprehensive and standardised definition of medical complexity and/or highlight key components required to define medical complexity in urgent care and emergency department settings.Methods and analysis This protocol is developed according to the approach described by Arksey and O’Malley (2005) and expanded by Levac and colleagues. We will use Walker and Avant’s method of concept analysis (2005) to gain a comprehensive understanding of the concept of medical complexity. We will systematically search MEDLINE, CINAHL Plus, EMBASE, APA PsycINFO and Cochrane Library. A grey literature search will be conducted in Google and Google Scholar to identify additional information. Two reviewers will independently screen titles and abstracts for inclusion, followed by a screening of the full text of potentially relevant articles. Relevant data will be extracted from these studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist will be used to report the selection of studies at different stages.Ethics and dissemination Scoping review methodology uses and reviews publicly available studies and data, so ethics approval is not required. We will disseminate the results of this scoping review through peer-reviewed publications and presentations at academic conferences and scientific meetings. We will also share these results with key stakeholders, including healthcare providers, community organisations and healthcare system leaders.
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spelling doaj-art-2287b4afbcf14cd7a3fe494dec6057612025-02-11T17:10:14ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-086984Medical complexity in emergency and urgent care settings: a scoping review protocolDiane Lorenzetti0Tanvir C Turin1Sumedh Bele2Eddy Lang3Doreen Rabi4Naomi Popeski5Marie-Claire Uwamahoro6Conne Lategan7Kate Yakubets8Cassandra Chisholm9Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaDepartment of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CanadaNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UKEmergency Medicine, University of Calgary, Calgary, Alberta, CanadaDepartment of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CanadaDepartment of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CanadaCommunity Health Sciences, University of Calgary, Calgary, Alberta, CanadaUniversity of Alberta College of Health Sciences, Edmonton, Alberta, CanadaUniversity of Calgary Cumming School of Medicine, Calgary, Alberta, CanadaUniversity of Alberta College of Health Sciences, Edmonton, Alberta, CanadaIntroduction Considering the impact of non-medical factors (personal and social) on patients with multiple chronic conditions, the term ‘medical complexity’ is gaining traction as it encompasses both medical and non-medical aspects of patients’ medical needs. When primary care is not able to provide timely care for chronic challenges or acute concerns, complex patients require care in emergency or urgent care settings. The concept of medical complexity is continually evolving, although without a universally accepted or standardised definition that determines if an adult patient is considered complex. Therefore, this scoping review aims to understand how medical complexity is defined, identify its defining attributes and examine its use in clinical care research. We also aim to consolidate and evaluate the evidence to suggest a more comprehensive and standardised definition of medical complexity and/or highlight key components required to define medical complexity in urgent care and emergency department settings.Methods and analysis This protocol is developed according to the approach described by Arksey and O’Malley (2005) and expanded by Levac and colleagues. We will use Walker and Avant’s method of concept analysis (2005) to gain a comprehensive understanding of the concept of medical complexity. We will systematically search MEDLINE, CINAHL Plus, EMBASE, APA PsycINFO and Cochrane Library. A grey literature search will be conducted in Google and Google Scholar to identify additional information. Two reviewers will independently screen titles and abstracts for inclusion, followed by a screening of the full text of potentially relevant articles. Relevant data will be extracted from these studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist will be used to report the selection of studies at different stages.Ethics and dissemination Scoping review methodology uses and reviews publicly available studies and data, so ethics approval is not required. We will disseminate the results of this scoping review through peer-reviewed publications and presentations at academic conferences and scientific meetings. We will also share these results with key stakeholders, including healthcare providers, community organisations and healthcare system leaders.https://bmjopen.bmj.com/content/15/1/e086984.full
spellingShingle Diane Lorenzetti
Tanvir C Turin
Sumedh Bele
Eddy Lang
Doreen Rabi
Naomi Popeski
Marie-Claire Uwamahoro
Conne Lategan
Kate Yakubets
Cassandra Chisholm
Medical complexity in emergency and urgent care settings: a scoping review protocol
BMJ Open
title Medical complexity in emergency and urgent care settings: a scoping review protocol
title_full Medical complexity in emergency and urgent care settings: a scoping review protocol
title_fullStr Medical complexity in emergency and urgent care settings: a scoping review protocol
title_full_unstemmed Medical complexity in emergency and urgent care settings: a scoping review protocol
title_short Medical complexity in emergency and urgent care settings: a scoping review protocol
title_sort medical complexity in emergency and urgent care settings a scoping review protocol
url https://bmjopen.bmj.com/content/15/1/e086984.full
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