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World medicine lacks knowledge on multi-morbidity - experts

Thursday April 19th, 2018

Treatment of people with multiple health conditions is often ineffective and strategies for prevention “lacking”, medical scientists warn today.

The result is growing numbers of people facing life-long disability or premature death, according to an investigation by the Academy of Medical Sciences.

The causes of the problem of multi-morbidity are poorly understood – and strategies for prevention lacking, according to the report, which involved 17 experts on global health.

It is increasingly common in young people as well as older patients, researchers say.

The report says the problems could afflict between 13% and 95% of patients globally, a range “so wide” that it indicates how little is known about the problem.

It highlights the “clustering” of physical and mental health conditions, pointing out that clinical trials often exclude people with multiple conditions.

Academy chair Professor Stephen MacMahon 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.”

He added: “How to prevent and manage multiple diseases is a challenge that GPs face every day, yet we have almost no evidence on which to provide guidance as to how to do this most effectively.

“We are facing a tidal wave of patients living with multiple long-term health conditions, and our report demonstrates how little we know about how to manage this. Outcomes appear to be worse in these patients and yet there is growing evidence that people with multimorbidity are less likely to receive appropriate care for the individual diseases they have.”

Academy president Professor Sir Robert Lechler said: “People living with more than one illness often have more medical appointments and medications to manage, and doctors can struggle to balance their care. The toll of this can have a big impact on the quality of life of patients and their families.

“So far medicine has excelled in treating single illnesses - but if we are to improve the quality of life for the millions living with multiple health conditions we must get better at treating the whole person and all of their illnesses.”

The Royal College of GPs has predicted the UK would have some 9.1 million patients with more than one serious, long-term condition by 2025 - a one million increase on the present.

Chair Professor Helen Stokes-Lampard said: “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.

“Care beyond general practice is also currently focused on single disease conditions, which can be fragmented and simply doesn’t work for patients living with more than one long-term illness who need individually-tailored treatment.

“As our patients live longer, they will inevitably do so with multiple, long-term conditions - and it’s important steps are taken to address the issues highlighted in this report sooner rather than later.”

Tags: General Health | UK News | World Health

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