New research from RCSI’s Department of General Practice has identified the most appropriate outcomes to assess in studies of patients with multimorbidity, the presence of two or more long term medical conditions. The research has been published in the leading US primary care journal, the Annals of Family Medicine.

Multimorbidity is common and affects more than half of people in Ireland over the age of 50. It may affect quality of life, and be associated with a decline in daily functioning and increased need for healthcare. Patients with multimorbidity often experience polypharmacy (i.e., the need to take several medications) and can experience fragmented care due to complex treatments with multiple healthcare providers.  

This study, led by Professor Susan Smith, identifies and prioritises outcomes that can be examined in studies of interventions for patients with multimorbidity. An international panel of experts was convened, featuring researchers, clinicians and patients from 13 countries. This panel recommends that clinical trials of multimorbidity should measure and report 17 core outcomes in total for multimorbidity research. The highest ranked outcomes focus on quality of life, mental health and mortality. 

According to Professor Smith: “The increase in long-term conditions and ageing populations mean that the number of patients with multiple health conditions is set to rise. There is growing interest in trying to identify effective interventions that can improve outcomes for patients with multimorbidity. Part of this involves identifying outcomes that matter most to patients and healthcare providers. We conducted a study with International researchers to identify which outcomes should be prioritised to improve management of multimorbidity in primary care.”

The most important outcomes identified were mortality, mental health outcomes and quality of life. Other outcomes focus on patient-reported impacts, including treatment burden, self-assessed health; physical activity; medical visit outcomes; and health systems outcomes, including quality and costs of healthcare. The researchers suggest that studies into multimorbidity include the most improtant outcomes identifited and also consider the full range of other outcomes depending on the nature of their own individual study.

The study was carried out by the Health Research Board (HRB) Centre for Primary Care Research at RCSI's Department of General Practice in collaboration with researchers from the University of Bristol, the University of Sherbrooke in Canada and the University of Colorado in the USA.

The paper 'A Core Outcome Set for Multimorbidity Research' is published the March/April issue of the Annals of Family Medicine and can be read here.