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. 2024 Dec 18;24(1):3446.
doi: 10.1186/s12889-024-20763-8.

The impact of living with multiple long-term conditions (multimorbidity) on everyday life - a qualitative evidence synthesis

Emilia Holland  1 , Kate Matthews  2 , Sara Macdonald  3 , Mark Ashworth  4 , Lynn Laidlaw  5 , Kelly Sum Yuet Cheung  6 , Sebastian Stannard  2 , Nick A Francis  2 , Frances S Mair  3 , Charlotte Gooding  2 , Nisreen A Alwan  2   7   8 , Simon D S Fraser  2   8
Affiliations

The impact of living with multiple long-term conditions (multimorbidity) on everyday life - a qualitative evidence synthesis

Emilia Holland et al. BMC Public Health. .

Abstract

Background: Multiple long-term conditions (MLTCs), living with two or more long-term conditions (LTCs), often termed multimorbidity, has a high and increasing prevalence globally with earlier age of onset in people living in deprived communities. A holistic understanding of the patient's perspective of the work associated with living with MLTCs is needed. This study aimed to synthesise qualitative evidence describing the experiences of people living with MLTCs (multimorbidity) and to develop a greater understanding of the effect on people's lives and ways in which living with MLTCs is 'burdensome' for people.

Methods: Three concepts (multimorbidity, burden and lived experience) were used to develop search terms. A broad qualitative filter was applied. MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (EBSCO), CINAHL (EBSCO) and the Cochrane Library were searched from January 2000-January 2023. We included studies where at least 50% of study participants were living with three or more LTCs and the lived experience of MLTCs was expressed from the patient perspective. Screening and quality assessment (CASP checklist) was undertaken by two independent researchers. Data was synthesised using an inductive approach. PPI (Patient and Public Involvement) input was included throughout.

Results: Of 30,803 references identified, 46 met the inclusion criteria. 31 studies (67%) did not mention ethnicity or race of participants and socioeconomic factors were inconsistently described. Only two studies involved low- and middle-income countries (LMICs). Eight themes of work were generated: learning and adapting; accumulation and complexity; symptoms; emotions; investigation and monitoring; health service and administration; medication; and finance. The quality of studies was generally high. 41 papers had no PPI involvement reported and none had PPI contributor co-authors.

Conclusions: The impact of living with MLTCs was experienced as a multifaceted and complex workload involving multiple types of work, many of which are reciprocally linked. Much of this work, and the associated impact on people, may not be apparent to healthcare staff, and current health systems and policies are poorly equipped to meet the needs of this growing population. There was a paucity of data from LMICs and insufficient information on how patient characteristics might influence experiences. Future research should involve patients as partners and focus on these evidence gaps.

Keywords: Burden; Impact; Lived experience; Long-term conditions; Multimorbidity; Work.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethics approval has been obtained for the MELD-B study from the University of Southampton Faculty of Medicine Ethics committee (ERGO II Reference 66810). A separate application was made for the Qualitative Evidence Synthesis with no further review required. Consent for publication: This is a secondary analysis of previous qualitative research. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study identification process
Fig. 2
Fig. 2
Summary of the quality assessment of included studies
Fig. 3
Fig. 3
Themes of work. Footnote: The outer oval includes examples of concepts in each theme (not an exhaustive list)
Fig. 4
Fig. 4
Summary of which themes of work were covered by which papers
See this image and copyright information in PMC

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References

    1. Harrison C, Fortin M, van den Akker M, Mair F, Calderon-Larranaga A, Boland F, et al. Comorbidity versus multimorbidity: Why it matters. J Multimorb Comorb. 2021;11:2633556521993993. - PMC - PubMed
    1. Chowdhury SR, Chandra Das D, Sunna TC, Beyene J, Hossain A. Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis. EClinicalMedicine. 2023;57:101860. - PMC - PubMed
    1. Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ, et al. Multimorbidity Nat Rev Dis Primers. 2022;8(1):48. - PMC - PubMed
    1. Quinaz Romana G, Kislaya I, Cunha Gonçalves S, Salvador MR, Nunes B, Matias DC. Healthcare use in patients with multimorbidity. Eur J Public Health. 2020;30(1):16–22. - PubMed
    1. Richmond Group of Charities. “Just one thing after another”: Living with multiple conditions - A report from the Taskforce on Multiple Conditions. 2018. Available from: https://richmondgroupofcharities.org.uk/sites/default/files/final_just_o.... Accessed June-September 2022.

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