Effectiveness of Community Nurse-Led Intervention in Managing Older Adults with Multimorbidity: A Systematic Review of Randomized Controlled Trials

Background: Multimorbidity is highly prevalent among older adults and poses significant challenges to healthcare systems globally, especially in low and middle-income countries. Nurse-led interventions are considered a promising strategy for addressing the complexity of care required for older adults with multiple chronic conditions. Purpose: This systematic review aimed to synthesize empirical evidence on the effectiveness of nurse-led interventions in improving health outcomes among older adults with multimorbidity. Methods: A systematic literature search was conducted across five major databases (PubMed, CINAHL, ScienceDirect, Scopus and Taylor & Francis) without time restriction. Randomized controlled trials (RCTs) focusing on nurse-led interventions in older adults with two or more chronic conditions were included. The methodological quality of studies was assessed using the Risk of Bias assessment. Data were extracted and synthesized qualitatively. Results: A total of nine RCTs met the inclusion criteria. The interventions varied in design, setting, and duration. The interventions were categorized into three themes: (1) nursing care transitions, (2) strengthening self-management programs, and (3) integrated collaborative care. Community nurse-led interventions have consistently demonstrated effectiveness in improving physical function, chronic disease management capacity, medication adherence and knowledge, and perceptions of service quality and coordination. This intervention also contributed to a reduction in readmission rates, use of home care services, and length of stay in a secondary care facility. Conclusion: Nurse-led interventions demonstrate strong potential in supporting older adults with multimorbidity by enhancing self-management capacity, optimizing care transitions, and improving intersectoral coordination. To maximise impact, future implementation in developing countries like Indonesia should consider cultural adaptability, primary care readiness, and system sustainability.