Abstract
Globally, the number of people with multiple co-occurring diseases will increase substantially over the coming decades, with important consequences for patients, carers, healthcare systems and society. Addressing this challenge requires a shift in the prevailing clinical, educational and scientific thinking and organization—with a strong emphasis on the maintenance of generalist skills to balance the specialization trends of medical education and research. Multimorbidity is not a single entity but differs quantitively and qualitatively across life stages, ethnicities, sexes, socioeconomic groups and geographies. Data-driven science that quantifies the impact of disease co-occurrence—beyond the small number of currently well-studied long-term conditions (such as cardiometabolic diseases)—can help illuminate the pathological diversity of multimorbidity and identify common, mechanistically related, and prognostically relevant clusters. Broader access to data opportunities across modalities and disciplines will catalyze vertical and horizontal integration of multimorbidity research, to enable reconfiguring of medical services, clinical trials, guidelines and research in a way that accounts for the complexity of multimorbidity—and provides efficient, joined-up services for patients.
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Acknowledgements
We thank J. Carrasco-Zanini, M. Pietzner and H. Hemingway for assistance with references, figures and comments on an earlier draft of this Review. C.L. and A.D.H. are supported by the UK Research and Innovation (UKRI) Strategic Priority Fund Tackling multimorbidity at scale programme (grant number MR/V033867/1) delivered by the Medical Research Council and the National Institute for Health and Care Research (NIHR) in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council. A.D.H. is funded by the NIHR University College London Hospitals NHS Trust Biomedical Research Centre.
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Langenberg, C., Hingorani, A.D. & Whitty, C.J.M. Biological and functional multimorbidity—from mechanisms to management. Nat Med 29, 1649–1657 (2023). https://doi.org/10.1038/s41591-023-02420-6
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DOI: https://doi.org/10.1038/s41591-023-02420-6
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