MLTC not accounted for in clinical guidelines

Research conducted by the AGE Research Group in collaboration with the NIHR HealthTech Research Centre in In-vitro Diagnostic and Technology Evaluation has found that clinical guidelines often do not account for the impact of multiple long-term conditions.

The study, published in BMJ Medicine https://bmjmedicine.bmj.com/content/5/1/e001495 analysed 56 guidelines for different conditions published by the National Institute for Health and Care Excellence (NICE) and found that only 1 in 5 guidelines specifically accounted for the presence of MLTC. Most guidelines gave some advice on how to tailor care for a given condition in the presence of another condition, but most guidelines considered only a handful of closely-related conditions.

The research was conducted with colleagues in the HealthTech Research Centre as part of the Medical Research Council and NIHR funded ADMISSION programme, led from Newcastle in collaboration with partners in Birmingham, Manchester Metropolitan, University College London and Dundee Universities.

Professor Miles Witham, lead author on the study, commented:

“Millions of people live with multiple long-term conditions in the UK, and most people we see in clinical practice have several conditions that they have to juggle care for. Our public contributors tell us that balancing the different aspects of care and treatment for several conditions at once is a major challenge for them, and they often feel that only one condition gets treated at a time, with the other conditions ignored”

“Guidelines are central to how healthcare teams work, and so they need to be flexible and adaptable enough to allow patients and clinicians to find that balance of care across multiple conditions. We found some very good examples for some condition guidelines, which included a wider range of coexisting conditions and specific advice on how to adapt care for people with MLTC. Learning from these examples along with greater involvement of people living with MLTC on guideline development committees would lead to guidelines that better meet the needs of this under-served group of patients”

An editorial accompanies the paper and can be found here: https://bmjmedicine.bmj.com/content/5/1/e002605