People with multimorbidity (two or more coexisting conditions in an individual) are more likely to die prematurely, be admitted to hospital and have an increased length of stay than people with a single chronic condition.
Multimorbidity is also associated with poorer function and health-related quality of life (HRQOL), depression and intake of multiple drugs (polypharmacy) and greater socioeconomic costs. Most health care is designed to treat individual conditions rather than providing comprehensive, person-centreed care, which often leads to fragmented and sometimes contradictory care for people with multimorbidity and increases their treatment burden. Moreover, treating one condition at a time is inefficient and unsatisfactory for both people with multimorbidity and their health-care providers.
Multimorbidity (two or more coexisting conditions in an individual) is a growing global challenge with substantial effects on individuals, carers and society. Multimorbidity occurs a decade earlier in socioeconomically deprived communities and is associated with premature death, poorer function and quality of life and increased health-care utilization. Mechanisms underlying the development of multimorbidity are complex, interrelated and multilevel, but are related to ageing and underlying biological mechanisms and broader determinants of health such as socioeconomic deprivation. Little is known about prevention of multimorbidity, but focusing on psychosocial and behavioural factors, particularly population level interventions and structural changes, is likely to be beneficial. Most clinical practice guidelines and health-care training and delivery focus on single diseases, leading to care that is sometimes inadequate and potentially harmful. Multimorbidity requires person-centred care, prioritizing what matters most to the individual and the individual’s carers, ensuring care that is effectively coordinated and minimally disruptive, and aligns with the patient’s values. Interventions are likely to be complex and multifaceted. Although an increasing number of studies have examined multimorbidity interventions, there is still limited evidence to support any approach. Greater investment in multimorbidity research and training along with reconfiguration of health care supporting the management of multimorbidity is urgently needed.