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NHS Research Scotland Champion urges action after groundbreaking study into multiple long-term health conditions
16th January 2025
A pioneering study led by the NHS Research Scotland (NRS) Primary Care Network Champion has found that certain combinations of long-term health conditions are associated with worse quality of life — but can benefit from tailored treatments and interventions if actioned
Dr Bhautesh Jani spearheaded the UK-wide study, entitled ‘Multimorbidity clusters and their associations with health-related quality of life in two UK cohorts’.
Its findings suggest that some combinations of multiple long-term health conditions (MLTCs) — such as chronic pain, depression, and cardiovascular disease — may have a worse impact on quality of life than others.
The study, published in BMC Medicine, recommends that healthcare settings urgently “facilitate the development of effective and cost-effective targeted healthcare strategies" in order to better assess, treat, and monitor affected patients.
The researchers believe that “improved survival of people living with long-term conditions (LTCs), coupled with increasing life expectancies and generational shifts in lifestyle behaviours, such as diets and physical activity” have resulted in the growth of MLTCs across the world.
Furthermore, they note that “healthcare services are almost universally designed around the treatment of single conditions and are, therefore, inadequate to meet the more complex needs of people living with MLTCs”.
This, they believe has led to people with MLTCs experiencing issues such as fragmented healthcare, high treatment burden, and higher risk of premature mortality.
After analysing the health data of more than half a million people, the research team concluded it is vital that health service delivery planning, future intervention design, and risk assessment of people with MLTCs is reassessed to better meet the needs of specific patients.
Dr Jani, awarded an NRS Career Research Fellowship funded in 2017, and appointed as Primary Care Research Champion in 2021, said: “Treatment and monitoring of long-term conditions (sometimes referred as ‘secondary prevention’) is largely organised with a ‘one size fits all’ approach.
“This study has identified potential combinations of long-term health conditions which often have the worst impact on long-term health related quality of life. People with these combinations may benefit from tailored treatment and monitoring, which in turn may improve their long-term health and quality of life.”
The researchers — working on behalf of Personalised Exercise-Rehabilitation For people with Multiple long-term conditions (PERFORM) — identified 24 specific groups of conditions experienced by patients, some linked with worse overall quality of life.
In the UK, approximately 20-40% of adults are living with MLTCs. That figure rises to more than 50% in people over 65.
People living in socially disadvantaged areas are disproportionately impacted, with populations in these areas experiencing the onset of MLTCs up to two decades earlier than those in the least deprived areas.
The study states that the researchers’ work to identify MLTC clusters and their associated burden represented “a key priority to inform planning and development of effective healthcare services, potential treatments, and interventions, and to advance studies of mechanisms of MLTCs.”
It was added: “Raising awareness of these issues is important for medical educators and policy makers and to inform and influence service design and lead to better support for these patients.
“Improving Health-related quality of life (HRQoL) is a critical outcome for people living with MLTCs and their healthcare providers.”
Dr Jani is Clinical Senior Lecturer and Honorary Consultant at the University of Glasgow’s School of Health and Wellbeing. He was awarded a PhD in Primary Care Research in 2016 for his project entitled ‘Exploring the potential role of allostatic load biomarkers in risk assessment of patients presenting with depressive symptoms’.
NRS Primary Care Network is funded by the Chief Scientist Office (CSO) of Scottish Government to increase the amount of research relevant to patient care undertaken in a primary care setting.
