Improving the health of people with multimorbidity: the need for prospective cohort studies

The many challenges of multimorbidity The dramatic rise in long-term conditions (LTCs) represents a major challenge for individuals, families, and health care systems worldwide [1]. Due to the scale of this rise, the management of patients with LTCs largely falls within the domain of primary rather than secondary care, at least in countries with well-developed primary care systems. For example, in the UK, which has a comprehensive primary care system based around general practice (trained family physicians working in multidisciplinary teams) and funded by the National Health Service (NHS), primary care contacts account for around 90% of the total activity of the NHS, and patients with LTCs account for 80% of general practice consultations [2]. Effective primary care and community-based management of people with LTCs is thus a top priority [2?6].