Clinical assessment and management of multimorbidity: NICE guideline

INTRODUCTION

The National Institute for Health and Care Excellence (NICE) has published a guideline on the assessment and management of patients with multimorbidity.¹ Multimorbidity is defined as the presence of two or more long-term conditions and is increasingly common as people age.

Two-thirds of people aged >65 years will have multimorbidity, which is associated with reduced quality of life and higher mortality.² In older people this is associated with higher rates of physical health conditions, polypharmacy, adverse drug events, high treatment burden, and greater use of health services. In younger people and people from less affluent areas, multimorbidity is often due to a combination of physical and mental health conditions. The guideline emphasises that multimorbidity includes conditions such as sensory problems and pain as well as defined physical and mental health conditions such as diabetes or schizophrenia; ongoing conditions such as learning disability; symptom complexes such as frailty or chronic pain; sensory impairment such as sight or hearing loss; and alcohol and substance misuse.

The aim of this guideline is to support patients and clinicians in optimising care for people with multimorbidity, in particular where there is potential for care to become burdensome or uncoordinated.