Biological and functional multimorbidity-from mechanisms to management

Globally, the number of people with multiple co-occurring diseases will increase substantially over the coming decades, with important consequences for patients, carers, healthcare systems and society. Addressing this challenge requires a shift in the prevailing clinical, educational and scientific thinking and organization-with a strong emphasis on the maintenance of generalist skills to balance the specialization trends of medical education and research. Multimorbidity is not a single entity but differs quantitively and qualitatively across life stages, ethnicities, sexes, socioeconomic groups and geographies. Data-driven science that quantifies the impact of disease co-occurrence-beyond the small number of currently well-studied long-term conditions (such as cardiometabolic diseases)-can help illuminate the pathological diversity of multimorbidity and identify common, mechanistically related, and prognostically relevant clusters. Broader access to data opportunities across modalities and disciplines will catalyze vertical and horizontal integration of multimorbidity research, to enable reconfiguring of medical services, clinical trials, guidelines and research in a way that accounts for the complexity of multimorbidity-and provides efficient, joined-up services for patients.

Automated summary

Globally, the number of people with multiple co-occurring diseases is expected to rise in the future, which will have significant implications for various stakeholders. To address this challenge, there needs to be a shift in clinical, educational, and scientific thinking, emphasizing the maintenance of generalist skills alongside specialized medical education and research. Multimorbidity is not uniform, but varies across different factors, such as age, ethnicity, gender, socioeconomic status, and geography. Data-driven research can help quantify the impact of disease co-occurrence and identify common clusters, enabling a more comprehensive understanding of multimorbidity and the provision of efficient and integrated healthcare services for patients.