NICE Announces Multicomorbidity Management Guidelines

New guidelines for managing patients with more than one long-term condition have been released by the National Institute for Health & Care Excellence (NICE) and recommend an individualized approach to patient care, focused on patients’ personal preferences, needs, and priorities.

Research estimates that 2.9 million people will have three or more long-term health conditions by 2018. In addition, the more long-term physical conditions a person has, the more likely they are to also have a long-term mental health condition.

In order to reduce treatment burden and minimize unwanted side effects from taking multiple medicines, the guidelines suggest that clinicians stop treatment if it is considered to be of limited benefit; identify medicines with a higher risk of unwanted side effects; offer alternative treatment (nonpharmacological) to some medicines; and consider making alternative arrangements in order to make the best use of appointments a person has to attend, so that they do not have to prioritize conflicting appointments for different conditions (https://bit.ly/2dD1tIQ).

Along with the guidelines, NICE has also launched an online resource that allows users to access more than 200 video, audio, and written excerpts from interviews with real patients who discuss how they manage multiple complex illnesses (https://bit.ly/2cOcJ9r).

The main challenges facing patients with multiple comorbidities are managing sometimes conflicting treatments, deciding what to prioritize, coordinating the care received from different professionals, and generally overcoming poor communication from those professionals.

Research fellow Gavin Daker-White, PhD, University of Manchester (UK), who led the interview compilation project for the web source, believes that communication is the key to managing multicomorbidity. The online resource is meant to highlight some of the issues that need to be discussed and to provide support for patients.

The online resource is intended to guide patients not only in how to self-manage their treatment approaches across multiple conditions but also to help influence the tailored nature of treatment required by the new guidelines.—Amanda Del Signore