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Managing patients with multimorbidity: systematic review of interventions in primary care and community settings

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e5205 (Published 03 September 2012) Cite this as: BMJ 2012;345:e5205

Re: Managing patients with multimorbidity: systematic review of interventions in primary care and community settings

Very relevant article and good to see the issue of multimorbidity being addressed from a physiological perspective.

I do volunteer work in the area of co-morbidity in addiction and mental health and find it striking the disconnect between mental health and addiction services even though research (Wright et al) indicates 85% of people with alcohol problems also have a mental health problem. This leads to increased costs and poorer clinical outcomes. Interesting the Kings Hospital Trust published a report "Long-term conditions and mental health The cost of co-morbidities" which indicated £1 in £8 spent in the NHS could be saved by improved integration of mental health and chronic disease care services. It seems to me that a totally new care paradigm is needed for patients with complex conditions as the current framework relies on patients to integrate their care, yet patients are not empowered to do this.

Competing interests: No competing interests
14 September 2012
Carol Moore
Management Consultant in Healthcare
Dual Diagnosis Ireland
2a Orchard Road Clondalkin, Dublin 22
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