Multimorbidity poses global threat

MULTIMORBIDITY is common and on the rise worldwide but the causes are poorly understood and strategies for its prevention are lacking, according to a new report from the Academy of Medical Sciences.

Estimates for the percentage of patients affected world-wide by multimorbidity range from 13-95 per cent – a gap indicating just how little is known about this global burden.

The report was produced by a working group of 17 international health experts and is the first to address the problem of multimorbidity on a global scale. It highlights the inadequacy of the evidence required to guide health policy and medical practice.

Health conditions that frequently group together include heart disease, high blood pressure, diabetes, cancer, depression, anxiety, chronic obstructive pulmonary disease (COPD) and chronic kidney disease. It is unclear why some of these conditions cluster together, making it difficult to predict which patients may be most in need of preventive steps or increased care.

The report points out that most health services, including the NHS, are not designed to care for patients with multiple illnesses. This is likely to contribute to the increasing pressures on health systems and budgets worldwide, the report suggests. It concludes that without a better understanding of multimorbidity, it will not be possible for any country to plan future healthcare resources and redesign services effectively.

Professor Stephen MacMahon FMedSci, Chair of the Academy of Medical Sciences multimorbidity working group, said: "While we know multimorbidity is very common, we don’t know precisely how many people live with multiple serious illnesses. From what we do know, I estimate tens of millions of Britons suffer from multimorbidity, and globally the number could be a billion. Similarly, while we know multimorbidity is increasing, we don’t know how quickly or which groups are experiencing the biggest increases.

"This report should be the tipping point of recognising that multimorbidity is an enormous threat to global health. It is a priority to get the evidence we need to develop effective strategies for prevention and treatment."

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: "It's testament to the NHS that more of our patients are now living longer, but with an ageing population also comes more complex, chronic illnesses, and GPs are certainly seeing more of this every day on the front line. The College's own analysis has shown that the number of people living with more than one serious, long-term condition in the UK will increase by nearly 1million to 9.1million by 2025.

"GPs play a major role in looking after patients living with multi-morbidities, but often find ourselves coming up against barriers to their care. A lack of research, as this study highlights, into the extent of the crisis is one; another is understanding how best to treat patients living with both physical and psychological conditions – and having access to the most appropriate services to manage this in the community."