Multiple Long-Term Conditions

Call overview and agenda

On 8 September 2021, Professor Ioanna Tzoulaki and Dr Laura Downey presented the research plans for the proposed Multiple Long-Term Conditions Theme in the Imperial Biomedical Research Centre (BRC) (2022 to 2027) to members of the Imperial BRC Public Advisory Panel (Panel) via an online Zoom meeting

The aim of this particular online session was to:

• Introduce tthe Theme's propsed main areas of research
• Q&A
• Facilitate small group discussions exploring the topic further with panel members

Summary of Key Insights

The following is a summary of the themes identified from responses to each of the three questions, more details of which are set out in the full insight report.

What are North West London’s highest priority disease clusters?

Panel members were very supportive of research into clusters of disease linked to mental health as well as finding biomarkers for mental health. Other clusters identified as priorities were diabetes and cardiovascular diseases, allergies, immunology, and the mechanisms of autoimmune diseases. Frailty as well as inflammation were identified as priority areas.  There was wide support for addressing the treatment of one condition or its side effects then causing another condition e.g. medication for heart disease leading to kidney failure.  The need to look at intersectionality around sexuality, religion, socioeconomic status etc was considered a priority and not just looking at people in different silos e.g. men or women. Health inequalities and inequity was also considered a priority to include the specific protected characteristics covered by The Equality Act 2010. Lifestyle factors were considered relevant including those which did not necessarily link to socio-economic status. Links between obesity and deprivation, and obesity and high BMI generally underlying many conditions. Environmental aspects which for example, cause allergy symptoms were also considered to be very relevant especially in London. It was also recommended that a wider priority setting exercise be undertaken across North West London e.g. a James Lind Alliance priority setting exercise to find out from a larger number of people within the community what their research priorities are.

What are the top patient experience priorities?

The Panel agreed that communication between healthcare professionals was paramount and that improved sharing of information and communication between healthcare professionals and between different departments would improve patient experience. This was also reflected in a recentJames Lind Alliance Priority Setting Partnership on multi-morbidity. Linking up patients with the same conditions was seen as beneficial to patients so they could meet others like them. The use of “multi-morbidity or co-morbidity” was not considered to be easily understood by lay people and that using “more than one long term condition” was preferable and easier to understand. Plain language more generally was considered essential e.g. the meaning of primary and secondary care are not easily understood. Quality of life and quality of death (especially for family members) were also considered to be priorities for those with multimorbidities. Timing of appointments was also relevant for patient experience e.g. elderly people can’t use their travel cards early in the morning and no one with a condition would want to travel to an appointment during rush hour on public transport.

How can we best involve the NWL community throughout our research process?

Panel members suggested utilising existing connections with the White City community through Priya Pallan in the Societal Engagement Team to involve different groups of the community.

Other comments

Panel members were enthusiastic about, and supportive of, the Theme’s research plans and made some further recommendations to the Theme including utilising both qualitative and quantitative research to add strength to the discussion; utilising GPs to undertake surveys about those with co-morbidities if possible, utilising research from countries which may also be relevant for the North West London population including India, China as well as Eastern Europe. It was also recommended that the Theme collaborate with other research groups undertaking research on multimorbidity to ensure there is no duplication, including with the Applied Research Collaborative (ARC) North West London which also has a mental health theme.   

How we used the insights

This insight report summarising key points from the session was made available to Theme leads and the BRC Executive in order to shape the BRC application. The report was also provided to the Panel members who took part in the involvement activity. A full report on all public involvement activities undertaken in preparation for the BRC application can be found here.

We would like to thank all those members of the public who gave their time and thoughtful insights through these activities, and the researchers who engaged enthusiastically in the process.