Complex Multimorbidity

Purpose

This domain is about working collaboratively in ways that are safe, effective and provide a positive experience for patients with complex comorbidity.

Why is this important?

Driven predominantly by age, the number of people living with two or more medical conditions - currently around three million in England - is steadily increasing. But multimorbidity is not restricted to older citizens; it can occur at any stage of life, and there are strong associations between multimorbidity and socioeconomic disadvantage. This inexorable trend presents significant challenges to healthcare where greater specialisation, although it has improved our ability to treat single diseases, disadvantages an increasingly large proportion of the population. Treating each disease in a patient as if it exists in isolation complicates, confounds and duplicates interactions across the healthcare system and ultimately leads to poorer outcomes.

Domain learning outcomes

On completing this domain of the enhance programme, you will be able to:

• Co-create management plans with patients with multiple long-term conditions, taking a critical approach to the application of multiple clinical protocols while balancing risk and benefit.
• Routinely take action to reduce harm from over-investigation, multiple intervention, and polypharmacy.
• Identify common disease clusters, predicting the issues that may arise and manage accordingly.
• Work collaboratively across disciplinary, team and organisational boundaries to ensure that the care and resources deployed achieve the best possible health outcomes and experience for the individual.
• Identify and mitigate the issues and risks - adopting a biopsychosocial approach - for a frail and/or vulnerable individual with complex needs living in a variety of settings.

You can view the full chapter here.