In the context of an aging population, the number of cases of people with multimorbidity, or multiple health conditions, is increasing, creating significant healthcare challenges. Now, the first comprehensive systematic review in this field has found higher levels of multimorbidity in women. Equally as importantly, it has revealed the poor quality of evidence on this increasingly critical area of healthcare.
The review's main author, Professor Jose M Valderas, NIHR Clinician Scientist of the University of Exeter Medical School, is calling for better quality research to be supported as a priority, so that key decisions on healthcare policy can be evidence-based.
In this study, published on July 21 in open access journal PLOS ONE, an international group of experts analysed published data from studies in 12 countries. The work, supported by the National Institute for Health Research and Spain's Ministry of Science and Innovation, showed that the prevalence of multiple health conditions varied widely between the studies - from less than 15 per cent to more than 95 per cent. The definition of multimorbidity itself also varied, meaning that overall the evidence is poor quality.
Professor Valderas said: "It is now recognised that suffering from multiple health conditions is the norm in patients over the age of 65 who visit their family doctor, but it is also a very frequent problem in younger patients as well. To tackle this, policy makers are working to implement programmes and apply approaches to maintain a high standard of healthcare that deals with the individual holistically rather than through vertical disease oriented programmes. Yet our study reveals that the starting point of what we know about multimorbidity is very low indeed – this must be addressed if we are to be sure that the action we are taking is likely to be effective and efficient."
Multimorbidity increases the risk of premature death, hospitalisations, loss of physical functioning, depression, and worsening quality of life, translating into a substantial economic burden for health systems.
Professor Valderas said: "Despite the variations in the studies, one over-arching finding is that older women are more likely to have multiple health conditions than men. It has long been known that multiple conditions are likely to develop with age, and we had also observed that they were more frequent among women in a previous study with English patients. But this is the first verification using data from different countries all over the world. In our study we found that women may suffer from multiple conditions up to 62% more than men. We know that women live longer than men, but we mitigated for that factor and still found a stronger association among women. We must urgently investigate further why this effect could be, so that we can look towards prevention and targeted treatment."
Notes for editors
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.
About the University of Exeter Medical School
The University of Exeter Medical School is improving the health of the South West and beyond. We achieve this through the development of high quality graduates and engaging in world leading research that has international impact. We are investing in infrastructure for both teaching and research, with projects such as the £27.5 million new build Research, Innovation, Learning and Development Centre (RILD) an example of how we work with partners within the healthcare sector, including the NHS to achieve our ambitions.
As part of a Russell Group university, the newly-formed Medical School builds on the success of Peninsula College of Medicine & Dentistry, a 10-year partnership with Plymouth University. It combines world-class research with very high levels of student satisfaction. The University of Exeter Medical School's Medicine programme is ranked 8th in the Guardian University Guide 2015. Exeter has over 18,000 students and is ranked 7th in The Times and The Sunday Times Good University Guide league table 2014, and 10th in The Complete University Guide and 12th in the Guardian University Guide 2015. In the 2008 Research Assessment Exercise (RAE) 90% of the University's research was rated as being at internationally recognised. Exeter was The Sunday Times University of the Year 2012-13.