As the Academy publishes a global policy report into multimorbidity, experts comment on some of the most important findings. Find out what you should know about people living with multiple serious illnesses and read the full report and summary online.
- Multimorbidity affects quality of life of patients and their families
“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.”
Professor Sir Robert Lechler PMedSci, President of the Academy of Medical Sciences
- Some serious physical and mental illnesses group together more frequently than others
“The research community must focus its efforts on understanding the clustering of conditions; this will help identify new insights into disease mechanisms as well as how we should tackle a large and growing problem for society.”
Professor Christopher Whitty CB FMedSci, Chief Scientific Adviser for the Department of Health and Social Care
“Depression and alcohol abuse frequently co-exist with chronic non-communicable diseases and syndromes and worsen the quality of life and health outcomes of affected persons.”
Professor Vikram Patel, FMedSci, Research Fellow, Harvard Medical School, USA – speaking of the situation in India
- Multimorbidity affects a growing number of patients in the UK and globally
“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.”
Professor Stephen MacMahon FMedSci, Chair of the Academy of Medical Sciences multimorbidity working group
- We do not know enough about multimorbidity
“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. 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.”
Professor Stephen MacMahon FMedSci, Chair of the Academy of Medical Sciences multimorbidity working group
- More research into multimorbidity is urgently needed
“The Academy’s report on Multimorbidity should be a major stepping stone for the research community into a new era of discovery for this large area of science which is also practically very important for the future.”
Professor Christopher Whitty CB FMedSci, Chief Scientific Adviser for the Department of Health and Social Care
“Multimorbidity is not an intangible problem. Research can give us the evidence needed to tackle this major health challenge and improve patients’ lives across the globe.”
Professor Sir Robert Lechler PMedSci, President of the Academy of Medical Sciences
“Research has been hampered by not having an agreed definition of multimorbidity. The Academy report provides a new definition for multimorbidity, which should be adopted globally and outlines the priority areas for research. We also need clear multimorbidity reporting systems for doctors and researchers.”
Professor George Griffin FMedSci, Vice President International at the Academy of Medical Sciences
- Healthcare systems are not currently designed to treat patients with multiple illnesses
“Our health care system is traditionally arranged around caring for individual diseases. We need to reorganise the system to deal with the challenge of multimorbidity.”
Professor Melanie Davies, Professor of Diabetes Medicine, University of Leicester, UK
“Primary care is ill-prepared to care for patients with chronic conditions. As a result, many patients will seek care from specialist providers who focus solely on the specific disease or organ system of their expertise, often to the detriment of the management of the co-existing morbidities.
Professor Vikram Patel, FMedSci, Research Fellow, Harvard Medical School, USA
- Doctors will need to take into account multimorbidity to improve patient care
“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.”
Professor Sir Robert Lechler PMedSci, President of the Academy of Medical Sciences
“We need to adopt a person-centred approach to patient care, that is to focus on what matters to the patient rather than what is the matter with the patient, which is often the preoccupation of health care providers.”
Professor Vikram Patel, FMedSci, Research Fellow, Harvard Medical School, USA – speaking of the situation in India
- Multimorbidity affects the young as well as the old
“I am seeing more and more younger patients with type 2 diabetes, particularly under the age of 40, who are suffering from another condition. This is a real concern.”
Professor Melanie Davies, Professor of Diabetes Medicine, University of Leicester, UK
- Multimorbidity is a major global health challenge
“We know that multimorbidity poses a major health challenge in every country. Lower and middle income countries whose healthcare systems are currently developing, such as China, India, Brazil and South Africa, have unique opportunities to design services around patients with multiple health conditions.”
Professor George Griffin FMedSci, Vice President International at the Academy of Medical Sciences
To find out more about our work on multimorbidity, please visit our dedicated policy page.
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5 more views on multimorbidity from around the globe:
China
“Hundreds of millions of Chinese people are living with more than one long-term illness, and the problem is growing larger with more and more people living longer into old age. Having multiple illnesses increases the risks of dying, reduces levels of activity and wellbeing, and introduces a greater likelihood of missing medications or for drugs to interact with one another. However, as health services are conventionally organised around single disease areas, people with multiple illness have to see lots of doctors for different reasons which adds complexity, costs and problems with communications. Innovative integrated solutions such as increasing the skills of doctors in primary health care, use of digital health and electronic communications systems are required.”
Professor Craig Anderson, Executive Director, The George Institute for Global Health, China
India
“There is virtually no recognition of the burden of multiple morbidities in India or how these should be addressed in primary care, despite the mounting evidence that they disproportionately affect the poor and lead to catastrophic health expenditure and impoverishment.”
Professor Vikram Patel, FMedsci, Research Fellow, Harvard Medical School, USA
“India now has the largest population of individuals under the age of 60 with multi-morbidity due to a mix of chronic non-communicable diseases and infections. A combination of factors related to individual, sociocultural and health systems characteristics contribute to delayed recognition until several organ systems are involved and the affected individual has entered an ongoing spiral. These conditions are responsible for tens of millions of people being pushed down into poverty every year.
“Shortage of healthcare workers, strict compartmentalisation of disciplines and skewed development of healthcare facilities in favour of private sector contribute to a growing disparity in access to effective care. Solutions require innovative out-of-the-box thinking and adoption of approaches such as task shifting and supporting care delivery through remote technologies - all delivered in the context of existing health systems.”
Professor Vivekanand Jha, Executive Director, The George Institute for Global Health, India
Brazil
“Multimorbidity affects 24% of the Brazilian population, particularly women, the elderly and those with lower levels of education. There is no doubt that this rapidly increasing and complex phenomenon demands urgent national attention.”
Dr Christian Kieling, Assistant Professor of Child and Adolescent Psychiatry, Federal University of Rio Grande do Sul, Brazil
South Africa
“Multimorbidity is hardly a new phenomenon in South Africa. The country has been facing high prevalence of HIV and TB for decades. In 2018, the prevalence of all non-communicable diseases exceed HIV. Diabetes has doubled in the past 10 years and there are 25,000 new cases of hypertension in the public sector each month. TB coincident with diabetes is now a major burden.
“The increasing burden of this complex health challenge further aggravates a fragile healthcare system in which 30% of doctors serve 85% of the population. Because most public sector patients with multimorbidty are diagnosed late, life expectancy is limited. There is little guidance on how to manage multimorbidity.”
Professor Karen Hofman, Director, PRICELESS SA Research Unit, Johannesburg, South Africa
Australia
“The issue of multimorbidity is largely ignored in Australia. This affects a quarter of all Australians and it’s a rapidly growing problem but currently patients are not receiving the care they deserve.
“People are living longer than ever in Australia, but they are not living healthier lives. Instead, they are contending with a whole host of chronic diseases and their risk factors. Unfortunately, we have a healthcare system designed around treating individual diseases. This means that many patients are missing out on receiving best practice care which leads to unnecessary deaths and disability.
“We need a fundamental change at both the GP and hospital level and urgent research into the scale of multimorbidity. If we don’t act now this will overwhelm our future healthcare system and many millions of Australians will suffer as a result.”
Professor David Peiris, Director of Health Systems Science, The George Institute for Global Health, Australia
Multimorbidity: a priority for global health research - summary
