Researchers need to adapt to better meet the needs of patients who are living with multiple health conditions, according to a new report from the Academy of Medical Sciences, the Medical Research Council and the National Institute for Health Research.
Living with multiple long-term health conditions is a common and growing problem around the world, but the vast majority of medical research is aimed at treating or preventing just one disease in isolation.
Our new FORUM workshop report, which brings together cross-sector views in a neutral platform, highlights three key strategies that could help drive the change. It says researchers need to:
- Gather more data to fully understand the problem.
- Study the biology of how several conditions can develop in one person and how they are linked.
- Ensure patient trials of new treatments include people with multiple health conditions.
In the UK alone, an estimated 54% of people over the age of 65 already have multiple long-term health conditions.
In some cases, these conditions can share a common cause, for example diseases such as inflammatory bowel disease, rheumatoid arthritis and psoriasis can all be caused by an over-active immune system. In other cases, one problem increases the likelihood of another, for example many physical conditions can lead to mental ill health and vice versa.
Our new report – ‘Multimorbidity: Cross-sector opportunities for developing new interventions for patients with multiple long-term conditions’ – explains some of the steps needed to ensure research into new medicines will help these patients. For example, the vast majority of clinical trials are aimed at treating one disease, such as asthma or diabetes, and patients with coexisting conditions may be excluded from taking part. This makes it difficult for doctors to know how a new drug will affect patients with several conditions. But, by including patients with more than one condition, researchers will learn more about who will and won’t benefit from the new treatment.
The report also highlights the need for training researchers to work in this area, encouraging collaborations between groups with different expertise and ensuring that patients living with multiple health conditions are involved in every step of the research process. However, it does not cover all aspects of research, for instance, behavioural and social sciences also have a role to play in understanding and improving patient’s self-management of their conditions.
The Academy of Medical Sciences has been focusing on multimorbidity for the past three years, working to raise its profile, bringing together medical research organisations and putting together a package of resources to support research in this area. Our partner organisations, the Medical Research Council and the National Institute for Health Research, are also supporting research on multiple long-term conditions including offering dedicated funding.
The workshop, held in October 2020, was co-chaired by Pernille B. Laerkegaard Hansen, Senior Director and Head of Bioscience Renal for AstraZeneca and Professor of Cardiovascular and Renal Research at the University of Southern Denmark, and Paul Elliott FMedSci, Professor of Epidemiology and Public Health Medicine at Imperial College London. It included input from patients, doctors, scientists, and representatives from funding bodies and industry.
Professor Elliott said:
“We know that we are living longer, but the longer we live, the more likely we are to develop several problems with our health. However, we still don’t know enough about who is at risk and why, or how best to help people with different combinations of diseases.
The aim of this work is to shift the focus of medical research towards treating the patient, not just one condition. Reaching this aim will require a lot of effort and some changes to the way we are working, but this report provides some solutions and clarity on how we can progress.”