Multiple long-term conditions (multimorbidity)

A substantial and growing number of people around the world suffer from two or more long-term conditions, known as multiple long-term conditions (multimorbidity) (MLTC).

Having multiple long-term conditions affects quality of life, leads to poorer health outcomes and experiences of care, and accounts for disproportionate healthcare workload and costs. Professor Chris Whitty, Chief Medical Officer for England, has reiterated the importance of MLTC as a research priority. The National Institute of Health Research (NIHR) uses the term ‘multiple long-term conditions’ rather than multimorbidity, as this term is preferred and better understood by patients and the public.

Understanding and mapping the clusters of conditions that occur more frequently in the population than you would expect by chance is crucial for tackling the problem of MLTC. Advances in artificial intelligence, machine learning and statistical methods offer huge potential to identify and understand more about trajectories in the development of clusters of disease. It will enable us to:

  • uncover new mechanisms for disease
  • develop treatments
  • reconfigure services to better meet patients’ needs

The AI for Multiple long-term conditions (AIM) programme

The £23 million Artificial Intelligence for Multiple Long-Term Conditions (AIM) programme harnesses the potential of artificial intelligence (AI) and data science to address the challenges of MLTC.

This programme brings together advanced data science and AI researchers, with the health and social care research communities, to work together to better understand:

  • how conditions cluster over the life course
  • the trajectories of their development over time
  • wider determinants of clusters of MLTC aetiology (the causes of MLTC) and progression, taking a life-course approach

A better understanding of how conditions cluster together will offer new insights into the underlying biological mechanisms and how best to configure health and care services to provide holistic care for patients with MLTC.

The AIM programme offers two types of funding: awards of up to £5 million for research collaborations (for up to 36 months) and development awards of up to £120,000 (for up to 8 months) to support researchers that may need more time to develop their proposals and establish their research capacity before applying for a full research collaboration.

In recognition of the fact that MLTC research has been put in the ‘too difficult’ box for too long, the AIM programme also includes £3 million funding for a Research Support Facility (RSF) to support successful applicants to help overcome barriers to research and build a community of researchers in this important field. The RSF provides:

  • technical competencies and expertise (e.g. technical AI expertise, data curation resource development) to support data access and governance
  • support with community building and facilitating networks across disciplinary boundaries
  • proficiency in communicating evidence showing impact and supporting shared learning and synergies across programmes of work
  • expertise in patient and public involvement to ensure that people with MLTC are at the heart of research supported through the AIM programme

It will provide leadership to support the research collaborations to overcome the challenges in conducting AI and MLTC research.

The AIM call for research collaborations was launched on the 30 June 2020. Three research collaborations and 9 development awards have been funded in the first wave. The development award holders will be submitting an application for full research collaboration funding.

Find out more about research into MLTC

The NIHR has published a strategic framework which outlines:

  • what is meant by the term MLTC
  • the high-level research priorities in this area
  • what cultural changes will be needed to support and fund high quality research into MLTC.

Following the publication of the Academy of Medical Sciences (AMS) report ‘Multimorbidity: a priority for global health research’, and subsequent workshops, the NIHR, MRC, Wellcome and the AMS have come together to coordinate a cross-funder group to progress the research in this area. The group has published a framework which aims to deliver a step-change for understanding the clusters, mechanisms and causes, prevention, management and treatment of multimorbidity through research.