Multimorbidity: improving patients' quality of life

Providing effective, person-centred care to patients with multimorbidity is a key part of creating a modern 21st century NHS and a challenge to which general practice is very much at the forefront. 

The National Institute for health and Care Excellence (NICE), recommends a comprehensive approach to care, tailored to the patient’s needs[1], but multimorbidity is a challenging area with a significant evidence gap. The RCGP estimates that more than nine million people in the UK will live with more than one serious, long-term condition by 2025. 

People with multimorbidity generally have reduced quality of life, make greater use of health services and have poorer health than people without multimorbidity. Improving patient experience is one of the triple aims of healthcare, and as GPs, caring for patients with multiple long-term conditions remains a very real challenge which practice teams face. 

A study in this week’s National Institute for Health Research (NIHR) Signals (https://discover.dc.nihr.ac.uk/portal/search/signals), suggested that patient-centred care for people with multimorbidity improves patient experience, but has little impact on quality of life in this trial. This NIHR-funded trial conducted in 33 general practices in England and Scotland, is the largest to assess these care principles for multimorbidity. The results  of the 3D Study are interesting and, as noted by the authors, there are potential issues around the outcome measures, the length of the trial, and the medical nature of the intervention being tested. 

Another piece of research published this week was conducted by the Richmond Group Taskforce on Multiple Conditions, a collaboration between the Richmond Group of Charities, Guy’s and St Thomas’ Charity, and the RCGP. This ethnographic research gives a voice to people living with multiple long-term conditions, uncovers the range of complex factors that impact their daily lives and helps us to focus efforts on what matters. 

There is evidently no ‘one-size-fits-all’ approach to delivering patient-centred care, and it is important that we use current evidence as a basis for further research into different approaches that do improve patients' quality of life. 

The RCGP will host a Multimorbidity Conference on 25 October to discuss the challenges faced by general practice when caring for patients with multiple long-term conditions, especially when physical and mental conditions occur together. For more information and to register for the Conference, please visit the clinical events section of our website. 



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