Facing the challenge of multimorbidity*

Received: Jan 4, 2016; Accepted: Jan 25, 2016; Published: Feb 17, 2016 a specific condition that requires tailored solutions and approaches. The urgent need to tackle multimorbidity in a more strategic, holistic, and cost-effective manner was evident at the 18th European Health Forum Gastein, a leading annual health policy event in the European Union (EU), held in the autumn of 2015. This Forum attracted policymakers, clinicians, health service managers, patients, and a broad range of other stakeholders, all of whom were invited to attend a session entitled “Facing the Challenge of Multimorbidity”, which was supported by an unrestricted educational grant from MSD (a subsidiary of Merck & Co., Inc., NJ, USA). The session included presentations from many of Europe’s most influential policymakers, researchers, and campaigners on the issue of multimorbidity, and sparked lively discussions and debate. This supplement to the Journal of Comorbidity summarizes the presentations and discussions from this important meeting, and outlines many of the key challenges we are currently facing in the management of multimorbidity. In the first paper [9], the epidemiology, risk factors, and consequences of multimorbidity are reviewed, highlighting how relatively little we actually know about multimorbidity and its determinants, or the effectiveness or cost-effectiveness of current interventions. This lack of basic knowledge will continue to hamper the efforts of policymakers; however, work is already underway to fill some of these information gaps, and this paper outlines how the European Commission and other public bodies are contributing to this effort. The second paper in the supplement [10] focuses on different models of care and how they might be applied to people with multimorbidity to improve outcomes. Under current silo-based models, patients with multimorbidity Multimorbidity is a major public health challenge that is rising up the political and health agenda at an accelerated rate. Although the prevalence of multimorbidity increases with age, more than half of the population with multimorbidity are under the age of 65 years [1], with social deprivation a key determinant of multimorbidity in young and middle-aged adults [2,3]. From an individual’s perspective, multimorbidity reduces life expectancy [4–6], decreases physical functioning and quality of life [7], and increases the risk of depression and other mental health disorders [3]. From a healthcare provider’s perspective, multimorbidity is associated with increased health service use, a high risk of emergency and other hospital admissions, high rates of polypharmacy, and spiralling costs [8]. Current health systems, which are typically built around a single-disease framework, are poorly adapted to cope with patients with multimorbidity, who typically experience fragmented healthcare services, leading to potentially inefficient and ineffective care. It is increasingly clear that we need to change our perspective on multimorbidity in order to address it as Journal of Comorbidity 2016;6(1):1–3