Multiple long-term conditions affect more than 14 per cent of English population

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Doctor talking to patient in hospital

New Imperial led research has found that nearly 15 per cent of people in England are currently living with two or more health disorders.

Researchers from Imperial College London and the University of Leicester have been involved in the largest ever study on multiple long-term conditions (MLTC). Their findings show that nearly 15 per cent of people in England are currently living with two or more health disorders.

“The growing prevalence of MLTC demands our immediate attention, prompting the development of clinical guidelines for its management and the establishment of frameworks and definitions to guide global health research.” Professor Jonathan Valabhji Clinical Chair in Medicine, Department of Metabolism, Digestion and Reproduction

Previous research has found that people with MLTC have poorer health-related quality of life, poorer physical function, greater psychological needs, greater use of healthcare services and a higher mortality risk.The researchers examined the health records of more than eight million individuals living in England with MLTC to investigate how it dominates different age groups.

The findings identified a higher prevalence of multiple long-term conditions (MLTC) in older adults compared to younger people, with the results showing that MLTC affects 1,905,979 adults aged 80 years and over.

They found that cardiometabolic conditions and osteoarthritis were the most common health complications that affect older age groups, while asthma, autism and epilepsy were dominant in children aged up to 19 years old. In addition, the findings have revealed that people aged 20 to 49 years were most likely to develop depression and asthma, whereas those aged 50 to 59 were affected mainly by hypertension and depression.

The study also showed that men are at higher risk of being affected by MLTC compared to women, as well as those from the most deprived areas compared to those living in more affluent neighbourhoods.

Individuals from Asian backgrounds are also more likely to develop MLTC compared to White people, whereas those from Black, Mixed and other ethnic backgrounds are less likely, the research has reported.

Professor Jonathan Valabhji, Clinical Chair in Medicine at Imperial's Department of Metabolism, Digestion and Reproduction, NHS England Lead for MTLC and the lead author of the study said: “Our latest research reveals a significant and concerning statistic which underscores a critical challenge for the future of healthcare systems worldwide.

“The growing prevalence of MLTC demands our immediate attention, prompting the development of clinical guidelines for its management and the establishment of frameworks and definitions to guide global health research. It’s a pivotal moment in healthcare, and we must address this issue with precision and compassion.”

Professor Khunti, Director of the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) East Midlands and Co-Chair of Multiple Long Term Conditions Cross NIHR Collaboration said: “Through our extensive research, we’ve unveiled a startling reality that nearly 15 per cent of the population in England are affected by MLTC. While healthcare systems around the world have traditionally focused on single chronic conditions, our study is a clarion call for change.”

He added: “The era of MLTC is upon us, and it is imperative that our health systems adapt. This pioneering study is the largest ever population investigation into MLTC, and it highlights the urgent need for a comprehensive and holistic approach to managing the healthcare needs of this growing demographic.”

Ming Tang, Chief Data and Analytics Officer, NHS England said: “Our recent collaborative study aimed to shed light on the increasing prevalence of MLTC within our population. This research has offered valuable insights into the challenges our healthcare system faces in addressing the diverse healthcare needs of individuals with MLTC.”

They added: “While it provides essential data for health service delivery planning, the heterogeneity of MLTC poses a formidable challenge in optimising healthcare delivery. The findings underscore the need for a more tailored approach to meet the evolving health needs of our population.”

This work was undertaken as part of a working group including health data analysts from Outcomes Based Healthcare, NHS Arden & GEM’s Advanced Analytics Unit, and NHS England.


Prevalence of multiple long-term conditions (multimorbidity) in England: a whole population study of over 60 million peopleValabhji J, Barron E, Pratt A, et al. Journal of the Royal Society of Medicine. 2023;0(0). doi:10.1177/01410768231206033

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Benjie Coleman

Benjie Coleman
Department of Surgery & Cancer

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Email: b.coleman@imperial.ac.uk

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