A team of scientists has shared expert view on “multimorbidity” – two or more coexisting conditions in an individual – focusing on the occurrence of the condition, and clinical practices when providing care including treatment, management, and prevention.

Ifakara Health Institute’s seasoned social scientist, Dr. Sally Mtenga, contributed to the paper along with other researchers from Denmark, the UK, Canada, Brazil, Peru, the USA, India, and Ireland.
“Multimorbidity requires person-centered care, prioritizing what matters most to the individual and the individual’s carers, ensuring care that is effectively coordinated and minimally disruptive, and aligns with the patient’s values,” they suggest.

Despite little being known about the prevention of multimorbidity, the scientists urged for focus to be put on psychosocial and behavioral factors, particularly population-level interventions and structural changes, noting that, “interventions are likely to be complex and multifaceted.”

They also reviewed the global barriers and opportunities for multimorbidity management grouping them into 3 barriers and 1 opportunity. These include patient-level barriers, system-level barriers, barriers in Low Medium Income Countries (LMICs), and opportunities in LMICs.

Within the patient-level barriers, the scientists include factors such as lower health literacy and self-efficacy to navigate the health-care system, treatment burden, limited social and economic resources to support self-management (such as family support, employment and community support), environment (for example, living in a rural area far from health services), and inadequacy of financial protection to meet health-care or related costs as some of the key challenges.

System-level barriers include the availability of, appropriateness of, and access to services while barriers in LMICs are expected to be augmented and amplified in settings characterized by weak, fragmented, and acute-oriented healthcare delivery systems.

Reviewing the opportunities in LMICs, the scientists said: “There are opportunities to leverage innovative delivery channels, such as technology-enabled tools or mobile health for physical and mental chronic conditions and the utilization of non-health-care delivery settings…These can be aided by co-production approaches, which are likely to yield interventions responsive to people’s preferences, and, therefore, enhance patient-centered approaches.”

The scientists also noted the increasing number of studies examining multimorbidity interventions over the years however, they also mentioned: “the need for investment in multimorbidity research and training along with reconfiguration of health care supporting the management of multimorbidity” which is urgently needed.
The review paper, called the Primer was published in the Nature Reviews Disease Primers journal on July 14, 2022.