A substantial and growing number of people around the world suffer from two or more long-term conditions, referred to as multimorbidity. This poses many challenges for individuals, carers and the health and social care system. A recent Academy of Medical Sciences (AMS) report on Multimorbidity clearly identified multimorbidity research as an urgent priority for the UK and globally. A follow on cross-funder workshop further highlighted that understanding of disease clusters, the underlying mechanistic pathways within disease clusters, as well as, the impact of social, environmental and behavioural factors over the life course will be crucial to tackling multimorbidities.
Some of the work to explore disease associations and to better measure multimorbidity across the UK population has already begun via the MRC-NIHR pump-priming initiative and by Health Data Research UK (HDR UK) through its National Multimorbidity Resource project. However, large inter- and multi-disciplinary research collaborative efforts are needed to address current research gaps and achieve the required cohesion in this field.
This ambitious two-stage initiative aims to do this by providing developmental support in the first instance via rapid and modest “consolidator grants” (≈ £100k/ 6 months each) to allow the best groupings time to consolidate existing data or collaborations; obtain preliminary data and/or validate approaches to enable progression to a more substantial “Research Collaborative award” stage, which aims to fund a balanced research portfolio of several Research Collaboratives (£3-5m /2-4yrs each). Recognising the need to provide timely support and momentum to the field, those groups that are already at a more mature stage, having already developed multi-disciplinary networks and supporting data, there is an option to move straight to the Research Collaborative stage.
This initiative is designed to bring together researchers with diverse expertise including biological, clinical, socio-economic and innovative methodological capabilities, as well as patients and carers with lived experience of multimorbidity, to support coordinated and aligned efforts across the UK to tackle multimorbidity. It is expected that such interdisciplinary collaborations will have the ability to exploit large-scale, longitudinal, multi-modal data by, for example, complementing or enriching standard health records and clinical datasets with a wealth of information from other sources, utilising advanced statistical and informatic capabilities.
Dr Neha Issar-Brown, Head of Population and Systems Medicine said: “This ambitious new initiative is part of our longer-term ambition to advance multimorbidity research in the UK. It builds on the strong foundations we have laid, working with our partners at the NIHR, ESRC, AMS and HDRUK, to bring together the diverse, inter-disciplinary expertise crucial to help overcome the challenges of a system that is currently organised around single diseases. The ultimate objective is to enable a holistic approach by unpicking the wider determinants of multimorbidity, including the dynamic within and between biological, environmental, psychological and socioeconomic determinants in the development, trajectories and prevention and management of multiple long-term conditions.”