New framework sets out a vision for how the funding community will drive forward the research agenda to tackle the growing problem of people living with multiple long-term conditions (multimorbidity).
People with multiple long-term conditions are not receiving the evidence-based care they need because of a lack of research. The Academy of Medical Sciences, Medical Research Council (MRC), the National Institute for Health Research (NIHR), and Wellcome are addressing this by setting out to drive forward the multimorbidity research agenda in the UK and globally.
The new framework identifies areas where funders can to work together to support and develop the multimorbidity research landscape. It was developed through engagement with a wider group of research funders and charity groups.
Our global population is ageing and growing, which means more people are likely to be living with more than one long-term condition like cancer, diabetes, dementia or depression. In the EU alone, an estimated 50 million people suffer from multiple long-term conditions, with negative consequences for patients and healthcare systems.
“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.
In the current COVID-19 pandemic, people with some long-term conditions may be more vulnerable to severe disease if they get the virus, and have been advised to stay at home and ‘shield’. This has raised more complexities in delivering their care, and may have an impact on their mental health.
To tackle the complex problem of multiple long-term conditions, funders are taking multimorbidity out of the ‘too difficult’ box. The new framework provides a vision of the research needed to improve our understanding of multiple conditions, and the changes needed in our ways of funding and conducting research in this area.
“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.
While the COVID-19 pandemic has tested the limits of healthcare systems, it has also demonstrated the incredible flexibility of the NHS. This may reveal opportunities to rethink how we approach care for multiple long-term conditions, which has been identified as key to rise to the challenge of multimorbidity.
Another important aspect of addressing this challenge that is highlighted in the framework is including more people with multiple conditions in clinical trials. Trials frequently exclude these people under current practices, which means we cannot be sure drugs will be as safe or effective in these patients as expected.
We recognise that understanding multiple conditions cannot focus on biomedical aspects alone; the personal experiences of diverse patients must also be included, as a report by the Taskforce on Multiple Conditions illustrates.
This requires skilled teams working across multiple disciplines, such as social sciences, healthcare and biological sciences. We are pleased to see that is already a core feature of some research initiatives, such as the International Research Community on Multimorbidity.
It is encouraging to see the MRC, NIHR already commit funds for research on multiple long-term conditions and we believe shared and aligned ways of working are important for encouraging further work in this area. The funders hope that this framework offers a valuable tool to support new knowledge exchanges, funding and scientific collaborations.
“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.
Download the framework here. The Academy of Medical Science will continue to support this work through our collaboration with MRC, NIHR and Wellcome, our joint web resources, and our commitment to amend the framework over time to reflect new advances.