Clinical guidelines must take into account the growing number of older people in England living with more than one chronic condition, according to new research.
The study, which was conducted at the Leicester Diabetes Centre, University of Leicester, found that people over the age of 50 with “multimorbidities”, or more than one chronic condition, has risen by 10 per cent in the last 10 years.
In 2002/2003, 31.7 per cent of people over the age of 50 had multiple chronic conditions, including type 2 diabetes, high blood pressure and arthritis. By 2012/2013, this figure was 43.1 per cent.
The researchers have called on authors of clinical guidelines to take multimorbidities into account. The current structure of the NHS is geared towards treating individual chronic conditions, but conditions like diabetes – which, if not well-controlled, can lead to other chronic diseases – present a new and unprecedented challenge to the NHS.
The King’s Fund, a health charity that shapes health and social care policy and practice, has described long-term, complex conditions as “the most important challenge facing the NHS today,” and calls for a system that moves “away from a reactive, disease-focused, fragmented model of care towards one that is more proactive, holistic and preventive, in which people with long-term conditions are encouraged to play a central role in managing their own care.”
Professor Kamlesh Khunti, Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester, based at the Leicester Diabetes Centre, said: “The prevalence of multimorbidity, where people have more than one chronic condition, in older adults is steadily increasing over time.”
“The current models of care globally are based on the management of individual chronic conditions. However, given the increase in multimorbidity over the past 10 years and the complex needs of these patients, clinical guidelines need to address the challenges in management of multimorbidity and formulate best practices to guide clinical decision making for these patients.”
Dr. Nafeesa Dhalwani, also based at the Leicester Diabetes Centre, University of Leicester, said that “multimorbidity has become one of the main challenges in the recent years for patients, healthcare providers and the healthcare systems globally.”
The findings are published in the International Journal of Behavioural Nutrition and Physical Activity.

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