Tackling the challenges of living with multiple health conditions

Published by Arthritis Research UK | 3 May 2018

We know that many people with arthritis also live with other conditions – this is known as ‘multimorbidity’. Living with many conditions can have a huge impact on individuals: there can be more medication and medical appointments to manage, or one condition could impact on a person’s ability to manage another. It also has a knock-on effect on health and care, for example a ten-minute consultation with a GP may not be enough time to discuss the impact of many conditions. We believe it is one of the largest and most complex challenges facing our health and care systems today.

Our policy and campaigns teams heard from people across the country about their personal experience of managing multiple conditions, and featured some of these stories in our ‘Musculoskeletal conditions and multimorbidity’ report produced in Summer 2017.

Arthritis Research UK is passionate about ensuring that people with multiple long-term conditions can live as well as possible, for as long as possible. To make this a reality, health and care services, and the voluntary sector, need to come together to delay and prevent the development of many conditions, alongside making sure that those already living with multiple long-term conditions have joined up services they can call on for support.

To tackle this problem head on, our Chief Executive Liam O’Toole is leading the Richmond Group multimorbidity taskforce. The Richmond Group of charities work together to influence health and social care policy, with the aim of improving care and support for people living with long term conditions. This taskforce includes people living with multiple conditions, as well as representatives from the Richmond group, the Royal College of General Practitioners (RCGP) and Guy’s and St Thomas’ Charity.

The key priorities for the taskforce will be:

1. Ethnographic research – to better understand the lived experience of people with many health conditions.
2. The Richmond Group of Charities exploring how to improve co-ordination of our information and support offers; including how we can help GPs better understand and signpost to our offer.
3. Tackling deprivation - people living in deprived areas tend to develop multiple conditions earlier in life. We want to learn about ‘promising approaches’ and what works.
4. Encouraging prevention - especially the importance of physical activity.

Wendy lives with arthritis and diabetes and is a member of the taskforce. She shared her experiences after their first meeting, which took place on 20 April 2018:

“It’s very unusual to get to my age and not find yourself surrounded by friends and family with multiple conditions, some with including both physical and some with mental illness, or combinations of both. Unfortunately, at the moment, the way a person is seen by health professionals is defined by the one condition that they are experts in. I believe it is important to see the whole person, and to understand the causes of their illness and how they can impact on each other. Many patients with arthritis have had this chronic disease from early in their life and have more than one health problem e.g. they may be depressed because of chronic pain, they may become obese, develop high blood pressure and heart conditions due to immobility and lack of exercise because of inflamed joints, they may also develop other conditions due to the treatments they have, like myself developing diabetes and osteoporosis due to many years of having treatment with steroids. It is therefore important that patients who have arthritis are ‘in the room’ when multimorbidity is discussed. This initial meeting went at a fast pace, but everyone was given the opportunity to speak out and have their opinions heard. I was shocked when I discovered that multimorbidity appears 10 to 15 years earlier in people living in the most deprived areas. We had local experts from Lambeth and Southwark at the meeting, who have obviously been researching this for a long time and had a great deal of information to share. We also discussed how many conditions you have to have to be described as having multimorbidity. I hope patients like myself will continue to contribute as the voice of those living with multimorbidity. I also hope that future work has its focus on solutions that can be applicable nationally, and that ways of caring for patients in a non-traditional way will be developed.”

Arthritis Research UK hopes that by working with others, we will gain a better understanding of the nature and scale of the challenge of living with many conditions, how they can affect people’s lives, and to get to grips with why the system struggles to respond.

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