Clinical assessment and management of multimorbidity: summary of NICE guidance

Most people with a chronic condition have one or more other chronic conditions, and multimorbidity is the norm in older people (see infographic 1 and box1).1 Multimorbidity matters because it is associated with reduced quality of life, higher mortality, polypharmacy and higher rates of adverse drug events, and high use of unplanned health care.2 3 4 5 Those with multimorbidity frequently receive care from both primary care and multiple specialists, who may not be communicating effectively with each other.6 7 Clinicians express uncertainty about the balance of benefit and harm of treatments in people with multimorbidity because evidence is largely based on trials of interventions for single conditions, from which people with multimorbidity are often excluded.8 9 Guidelines derived from such trials may lead to burdensome levels of treatment or unfeasible patterns of healthcare use .10

There is increasing recognition that care for some people with multimorbidity needs reorganisation,11 12 13 14 although not everyone with multimorbidity will require additional support. This guideline is intended to provide guidance on the optimum management of people with multimorbidity who need an approach to care …