Rethinking hEalth policy in MultimorbidITy (REMIT): a population-based approach

Background  

Health services are typically designed to address individual diseases separately, with health policy and decision-making in the UK and worldwide providing recommendations for treatments in single diseases. However, for people living with two or more long-term diseases - referred to as multimorbidity - separate treatments for each long-term disease can be inappropriate. This can lead to over-treatment, increased risk of adverse effects from multiple treatments, greater health inequalities and poorer outcomes. New treatments for patients with multimorbidity are emerging, but methods for assessing them effectively are yet to be established. New methods that allow appropriate assessment in multimorbid patients, including assessment of health inequalities, are needed to improve access to promising interventions and outcomes for patients with complex care needs.

Aims of the research

This research aims to develop new methods to assess emerging treatments for people with multimorbidity. This new approach will allow healthcare decision-makers to make the best use of available resources to improve patient care. Informed and motivated by a multimorbidity case study in diabetes, chronic kidney disease and heart failure, this research will address the following key questions:

1. How do diseases accumulate and develop in patients over time, and what is their impact on patients?
2. Are patients from more deprived communities more affected by multimorbidity? 
3. Can we identify opportunities to screen for and prevent disease accumulation?
4. Are emerging treatments for multimorbidity more effective than current practice in patients with two or more long-term conditions?
5. Do emerging treatments work equally well regardless of patients' socioeconomic background?
6. What are the financial cost implications (positive or negative) of using emerging treatments for patients with multimorbidity?