Area of investment and support

Multimorbidity or multiple long-term conditions (MLTC)

This initiative aims to support and develop research on multimorbidity, working closely with other research councils, funders and stakeholders to bring about advances in this complex multidisciplinary area.

• Duration: Ongoing
• Partners involved: Medical Research Council (MRC) lead, Economic and Social Research Council (ESRC), Engineering and Physical Sciences Research Council (EPSRC). Partners: Department of Health and Social Care, National Institute for Health Research (NIHR)

The scope and what we're doing

Multimorbidity (or people living with multiple long-term conditions, including mental and physical conditions and long duration infectious diseases) is increasing, in absolute terms and relative to single diseases. It is associated with a reduction in quality of life, increased use of health services, and reduced life expectancy.

Research on multimorbidity has been identified as an urgent global priority, and is one of the seven health focus themes outlined in MRC’s delivery plan 2019. We are seeking to support and develop research in this important field and work closely with research councils across UK Research and Innovation (UKRI), other funders and stakeholders to facilitate the advance in this complex multidisciplinary area.

Why we're doing it

Around one in four people have two or more serious long-term conditions, according to a study by the Health Foundation. This proportion is considerably higher, reaching two-thirds, in people aged 65 years and over. The scale of the multimorbidity burden and the challenges it poses to the healthcare system require research across different settings and communities to better understand the causes of multimorbidity and to develop new ways to manage and treat multiple conditions.

In 2018, the Academy of Medical Sciences (AMS) published an international policy report evaluating the growing issue of multimorbidity as a global health challenge. The report summarised the existing evidence around multimorbidity and identified the following priorities for multimorbidity research, to identify:

• the trends and patterns in multimorbidity
• which multimorbidity clusters cause the greatest burden
• the determinants of the most common clusters of conditions
• the strategies that are best able to facilitate the simultaneous or stepwise prevention of chronic conditions that contribute to the most common multimorbidity clusters
• the strategies that are best able to maximise the benefits and limit the risks of treatment among patients with multimorbidity
• how healthcare systems can be better organised to maximise the benefits and limit the risks for patients with multimorbidity

Following the report, the academy, MRC, the National Institute for Health Research (NIHR) and Wellcome agreed to come together to coordinate a multimorbidity funders’ group. Working alongside other charities, this group published a cross-funder multimorbidity research framework (PDF) in June 2020. The goal was to help funders coordinate their efforts and initiatives, engage with each other and collectively reach out to their different research communities facilitating broader academic involvement.

Opportunities, support and resources available

How we support research into multiple long-term conditions

Tackling multimorbidity at scale – a UKRI initiative in partnership with the the National Institute for Health Research (NIHR)

A Strategic Priorities Fund initiative, Tackling multimorbidity at scale: understanding disease clusters, determinants and biological pathways was launched in 2019. The objective was to improve prevention, management and treatment of multiple long-term conditions through building the UK’s capacity for transformative research in this area.

We are seeking to develop this new field by moving away from a one disease, one mechanism approach. We want to understand the diverse determinants of multimorbidity better, including biological, environmental, psychological and socioeconomic factors, so we can unpick and target the common causes of multiple long-term conditions.

The initiative is delivered by MRC and NIHR, in partnership with ESRC and in collaboration with EPSRC. It supports a network of multidisciplinary research collaboratives that will use and build on the UK’s well-powered population and clinical cohorts and datasets to interrogate the dynamic interactions between diseases. This will also help identify intervention points to prevent the development of multimorbidity and better manage conditions for patient benefit.

Researcher-led applications to MRC research boards and panels

Research into multiple long-term conditions (multimorbidity) is funded across our boards and panels where it fits their remits. Researchers can submit applications to our regular funding opportunities, including through MRC boards:

• infections and immunity
• molecular and cellular medicine
• neurosciences and mental health
• population and systems medicine
• applied global health research.

Multimorbidity is an opportunity area for our Population and Systems Medicine Board which supports research related to the physiology and pathophysiology of all the major organs and systems.

Support and resources

Resources for researchers include:

• Multimorbidity: a priority for global health research – AMS report 2018 (PDF)
• Cross-funder multimorbidity research framework – June 2020 (PDF)
• Briefing: understanding the healthcare needs of people with multiple health conditions
• resources from the multimorbidity funders group
• NIHR strategic framework for multiple long-term conditions (multimorbidity)
• NICE: multimorbidity
• UK health data research alliance
• Health and social care costs of a selection of health conditions (Public Health England report, 2020).

Training

Research projects are eligible for all our training investments.

Find out about our training opportunities, especially for fellowships and studentships.

Past projects, outcomes and impact

Past projects

Pump-priming funding opportunities 2018 to 2019:

• Multimorbidity in the UK population: understanding disease clustering (2018)
• Immune-mediated inflammatory diseases: understanding common mechanisms (2018)
• GCRF global multimorbidity – seed-funding (2019)

Past activities

These include:

• multimorbidity workshop: cross-sector opportunities for developing new interventions for patients with multiple long-term conditions (October 2020)
• workshop: advancing research to tackle multimorbidity – UK and LMIC perspectives (June 2018)
• event: landing MLTC research in the health and care system (November 2022). Watch a video from the event on YouTube. Read the event summary (contains illustrations) and the video transcript

Supported studies

The Strategic Priorities Fund programme – tackling multimorbidity at scale: understanding disease clusters, determinants and biological pathways – supported six collaboratives:

• Multimorbidity Mechanism and Therapeutics Research Collaborative (MMTRC)
• ADMISSION UK: multimorbidity research collaborative on MLTC in hospital: from burden and inequalities to underlying mechanisms
• Multimorbidity and Pregnancy: Determinants, Clusters, consequences and Trajectories (MuM-PreDiCT)
• Genetic Evaluation of Multimorbidity towards Individualisation of Interventions (GEMINI)
• Physical and mental health multimorbidity across the lifespan (LIfespaN multimorbidity research Collaborative (LINC))
• Defining mechanisms shared across multi-organ fIbrosis to prevent the development of long-term multimorbidity (DEMISTIFI-Multimorbidity)

Please consult the collaboratives’ webpages for information about new publications, studies progress, patient and public involvement, and other news:

• ADMISSION
• MMTRC
• GEMINI

The programme also supported three communities of practice, led by early career researchers:

• MLTC-M community of practice in clinical context and pathways (clinical community of practice)
• MLTC-M community of practice in ECR training on best practice patient and public involvement with diverse populations
• MLTC-M community of practice in statistical methods for multimorbidity research

Read about MRC’s board funding decisions and project outcomes.

Other funded projects

These include:

• Multimorbidity in the UK population – funded proposals 2018
• Global multimorbidity – seed funding 2019

Who to contact

Ask a question about the programme

Email: multimorbidity@mrc.ukri.org

Last updated: 10 October 2023