What do we mean by ‘multimorbidity’?

Multimorbidity is becoming the norm, not the exception. There are currently 15 million people in the UK with long-term conditions. Of these, 6.75 million (45%) have more than one long-term condition. And this number is rising. Fast. We are witness to growing interest in multimorbidity among health services researchers, and among the policy community. However our ability to plan health services for the future is hampered by gaps in our current knowledge. For example, we have very limited epidemiological data on the prevalence of multimorbidity – at a national, or international level – or changes in the prevalence of multimorbidity over time. There is also some uncertainty about what the term ‘multimorbidity’ might mean.

At a simple level, multimorbidity could be defined as the co-existence within an individual of more than one long-term condition. In our increasingly frequent use of the term multimorbidity, there may be an inherent danger that the term ‘multimorbidity’ is treated like it means something more than it does. We may, perhaps, talk about patients with ‘two long-term conditions’ as if this were a homogeneous group with some clinical meaning. This could be quite misleading. For example, it might include a 57 year-old with renal failure and high blood pressure; and a 101 year-old with profound deafness and blindness. The way these conditions impact on quality of life, and the extent to which they are amenable to medical intervention, are likely to be very different for the two individuals described.

‘Multimorbidity’ is not an illness, or a diagnostic label. Further, the meaning of multimorbidity for the health of an individual and their use of health services varies, and depends very much on the specific long-term conditions, and the specific interactions between these conditions.

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