Multi-morbidity – the presence of two or more long-term health conditions and mental disorders – is already affecting a large number of people (by some estimates, around one third of the population), with figures set to rise further.
However, healthcare delivery tends to be organised around individual diseases rather than integrating management across multiple diseases. Patterns of co-occurring diseases as well as strategies that prevent or treat multi-morbidity differ between high-income countries and low- and middle-income countries (LMICs). Researchers need to capture the situation and conditions in LMICs to find ways to prevent and treat multi-morbidity.
At the 2017 GACD Network meeting, researchers with different specialisms identified their common interest in going beyond ‘their’ NCD and address multi-morbidity. This sparked the formation of the GACD Multi-morbidity Working Group, which has grown to 74 members from across disease areas, with around half of its members located in middle-income countries.
Key outcomes
Since its establishment, the group has tackled a series of tasks:
A joint statement and a policy brief to draw the attention of research funders and policy makers to the importance of multi-morbidity research.
Development of a set of core outcomes measures for multi-morbidity trials in LMICs, in consultation with LMIC stakeholders. This will enable research results from across studies to be combined, increasing the strength of the evidence and its potential for impact.
A research prioritisation exercise, consulting with GACD Network members to assemble a ‘top ten’ list of urgent questions linked to international health targets such as the 2030 SDGs.
Next steps
The working group’s efforts are galvanising the research community and preparing the ground for future multi-morbidity research. They have already addressed one of the GACD funders’ main concerns – a lack of robust multi-morbidity outcome measures. As a result of such progress in the field, the funders have agreed that the 2023 GACD call for proposals will fund ‘implementation science research focused on integrating interventions for optimising management and care for patients with multi-morbidity in LMICs as well as vulnerable populations in HICs’.
Full case study: Multi morbidity Working Group Impact
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