@article{200a45eb33ee4c72a791e2b9c12c2479,
title = "Multimorbidity",
abstract = "Multimorbidity (two or more coexisting conditions in an individual) is a growing global challenge with substantial effects on individuals, carers and society. Multimorbidity occurs a decade earlier in socioeconomically deprived communities and is associated with premature death, poorer function and quality of life and increased health-care utilization. Mechanisms underlying the development of multimorbidity are complex, interrelated and multilevel, but are related to ageing and underlying biological mechanisms and broader determinants of health such as socioeconomic deprivation. Little is known about prevention of multimorbidity, but focusing on psychosocial and behavioural factors, particularly population level interventions and structural changes, is likely to be beneficial. Most clinical practice guidelines and health-care training and delivery focus on single diseases, leading to care that is sometimes inadequate and potentially harmful. Multimorbidity requires person-centred care, prioritizing what matters most to the individual and the individual's carers, ensuring care that is effectively coordinated and minimally disruptive, and aligns with the patient's values. Interventions are likely to be complex and multifaceted. Although an increasing number of studies have examined multimorbidity interventions, there is still limited evidence to support any approach. Greater investment in multimorbidity research and training along with reconfiguration of health care supporting the management of multimorbidity is urgently needed.",
keywords = "Humans, Multimorbidity, Quality of Life",
author = "Skou, {S{\o}ren T} and Mair, {Frances S} and Martin Fortin and Bruce Guthrie and Nunes, {Bruno P} and Miranda, {J Jaime} and Boyd, {Cynthia M} and Sanghamitra Pati and Sally Mtenga and Smith, {Susan M}",
note = "Funding Information: S.T.S. is currently funded by a program grant from Region Zealand (Exercise First), and two grants from the European Union{\textquoteright}s Horizon 2020 research and innovation programme, one from the European Research Council (MOBILIZE; grant agreement no. 801790) and the other under grant agreement no. 945377 (ESCAPE). F.S.M. undertakes multimorbidity research funded by the Wellcome Trust, National Institute for Health and Care Research (NIHR202020); UKRI (NIHR203986, NIHR202644); and MRC (MR/T037849/1, MR/T03775X/1). M.F. was funded by the Canadian Institutes of Health Research. B.P.N. receives research grants from the Research Support Foundation of Rio Grande do Sul, Brazil (grants 19/2551-0001231-4, 19/2551-0001704-9 and 21/2551-0000066-0 – Programa Pesquisa para o SUS: gest{\~a}o compartilhada em sa{\'u}de - PPSUS) related to projects on multimorbidity, and is a member of the Brazilian Group of Studies on Multimorbidity (GBEM). C.M.B. is funded by the National Institutes of Health, K24 AG056578, 1P30AG066587 and R24 AG064025. J.J.M. acknowledges having received support from the Alliance for Health Policy and Systems Research (HQHSR1206660), Biotechnology and Biological Sciences Research Council (BB/T009004/1), Bernard Lown Scholars in Cardiovascular Health Program at Harvard T.H. Chan School of Public Health (BLSCHP-1902), Bloomberg Philanthropies (via University of North Carolina at Chapel Hill School of Public Health), FONDECYT via CIENCIACTIVA/CONCYTEC, British Council, British Embassy and the Newton-Paulet Fund (223-2018, 224-2018), DFID/MRC/Wellcome Global Health Trials (MR/M007405/1), Fogarty International Center (R21TW009982, D71TW010877, R21TW011740), Grand Challenges Canada (0335-04), International Development Research Center Canada (IDRC 106887, 108167), Inter-American Institute for Global Change Research (IAI CRN3036), Medical Research Council (MR/P008984/1, MR/P024408/1, MR/P02386X/1), National Cancer Institute (1P20CA217231), National Heart, Lung and Blood Institute (HHSN268200900033C, 5U01HL114180, 1UM1HL134590), National Institute of Mental Health (1U19MH098780), Swiss National Science Foundation (40P740-160366), UKRI GCRF/Newton Fund (EP/V043102/1), Wellcome (074833/Z/04/Z, 093541/Z/10/Z, 103994/Z/14/Z, 107435/Z/15/Z, 205177/Z/16/Z, 214185/Z/18/Z, 218743/Z/19/Z) and the World Diabetes Foundation (WDF15-1224). B.G. was supported by Legal and General PLC (research grant to establish the independent Advanced Care Research Centre at University of Edinburgh). S.M.S. was supported by a Health Research Board Collaborative Doctoral Award in Multimorbidity (HRB CDA-2013-008, Prof. Susan Smith). The authors acknowledge J. Larkin, HRB Collaborative Doctoral Award PhD Scholar (HRB CDA-2013-008, Prof. Susan Smith), who supported us in the preparation of the manuscript by retrieving, organizing and inserting references via EndNote. Publisher Copyright: {\textcopyright} 2022, Springer Nature Limited.",
year = "2022",
month = jul,
day = "14",
doi = "10.1038/s41572-022-00376-4",
language = "English",
volume = "8",
pages = "48",
journal = "Nature Reviews Disease Primers",
issn = "2056-676X",
publisher = "Nature Publishing Group",
number = "1",
}