One of the greatest challenges for healthcare is multimorbidity: the presence in one person of multiple long-term diseases. At least a quarter of the UK population have more than one long-term disease, and those that do are more frequent users of NHS services.
The specific diseases an individual has affects how they interact with the NHS and how long they can expect to live. However, the way healthcare is designed ignores the problem or treats multimorbidity in an overly simplistic way, as present or absent.
In a new study, published on 10 April 2020 in BMC Medicine, Dr Steven Kiddle, Dr Yajing Zhu (MRC Biostatistics Unit) and Dr. Rupert Payne (University of Bristol) worked with PCU colleagues Professor Jonathan Mant and Dr Duncan Edwards to find groups of patients with similar combinations of diseases, using English GP healthcare records. The team assessed which combinations most affect use of NHS services and how long patients can expect to live.
The results showed an unmet need to improve outcomes for younger patients with combinations of drug abuse, alcohol abuse and depression.
In addition, it was discovered that chronic pain was a common feature of a majority of groups of patients with multiple long-term diseases, showing the importance of considering multiple diseases when managing pain.
The results also demonstrated that the majority of patients over the age of 85 who have multiple long-term diseases had low NHS use and risk of death, in comparison to other groups of multimorbid patients. This finding has implications for the design of the NHS and for further research into improving care for patients with multiple long-term diseases.
Diagram description: The columns are groups of patients 45 – 64 years old we have discovered with more than one long-term condition. The rows correspond to different conditions they can have. The percentages and bars represent how many people in each group have each condition.
Read the research paper in BMC Medicine: Y Zhu, D Edwards, J Mant, R Payne, S Kiddle, ‘Characteristics, service use and mortality of clusters of multimorbid patients in England: a population-based study‘. Published in BMC Medicine on 10 April 2020. https://doi.org/10.1186/s12916-020-01543-8
Lucy Lloyd, Communications, Primary Care Unit