Understanding success and failure in multimorbidity: protocol for using realist synthesis to identify how social learning and workplace practices can be optimised

Sarah Yardley, Elizabeth Cottrell, Joanne Protheroe

Multimorbidity is increasingly prevalent but, aside from epidemiological work, the impact on associated provision of healthcare and/or education is little understood. For example, it is unclear how or why healthcare interventions meet (or do not meet) people's multiple needs. Professionals working in primary care training sites must reconcile two goals: provision of appropriate individualised healthcare and provision of constructive workplace-based learning for future professionals. Given that professionals, learners and patients may have differing priorities and conceptualisations of success and failure in the absence of cure, achievement of both goals depends on social and cultural mechanisms. This review aims to make sense of how healthcare delivery for, and education about, multimorbidity can be concurrently delivered in primary care through identification of relevant theoretical frameworks.