Professor Stephen MacMahon FMedSci, Chair of the working group, has provided some perspectives on the progress of the project and its next steps.
I am delighted to Chair the Academy's newest policy project, which aims to address the issue of multimorbidity in an international context. Multimorbidity is a growing health concern across the world, so this ambitious project is highly timely.
At first glance, the concept of multimorbidity may seem simple – typically the term is used to refer to the co-existence of two or more chronic diseases in an individual. However, not everyone uses the same definition – for example, which diseases should be included or excluded, what constitutes ‘chronic’, and is it helpful to include acute diseases? Without a standardised approach, it is often difficult to compare different sources of evidence, each of which may be based on a different understanding of the problem. At our first working group meeting in October 2016 we discussed how this is a challenge for the analysis of multimorbidity studies, and we will explore this issue further as the project progresses.
The project will also aim to summarise the existing evidence on the mechanisms underlying the development of multimorbidity, and on how best to prevent and manage it. Once we understand this, we will be better able to identify what future research is needed to improve our understanding and care of this difficult issue. Importantly, we plan to explore these topics across a variety of countries, including low and middle income countries where multimorbidity is increasingly becoming a challenge for healthcare providers.
Since launching the project in September 2016, we have already engaged in numerous activities to gather such evidence. During our second working group meeting, we reviewed the submissions received to our call for written evidence, which we issued at the start of the project to gather views from a wide range of individuals and organisations. We also heard oral evidence from Professor Susan Smith, Dr Lynne Corner and Professor Stuart Parker; this gave us a real insight into the challenges of managing patients with a multiplicity of conditions, which requires a different approach than for the treatment of a single disease. We also discussed the findings of a two-day workshop in Johannesburg that I recently co-Chaired with Professor Karen Hofman, in which we heard about the burden of multimorbidity in South Africa and asked how we might achieve a more coherent and consistent approach to defining, researching and addressing multimorbidity. We considered how we can incorporate all this available evidence into the project’s report, which will ultimately make recommendations on how to best address the research gaps in this complex field.
Our report is in the initial stages, and will continue to evolve in the coming months. We will hold two further working group meetings, and plan to publish our report later this year. The passionate discussions that took place at our first two meetings have revealed the dedication that the working group has to this project. I am confident that our team of experts will enable this project to be both highly informative and highly influential to policymakers and other stakeholders across the globe.