New NICE guideline supports people with multiple long-term health conditions
In a new Clinical Guideline on multimorbidity, NICE calls for a tailored approach to care when treating people with two or more long-term health conditions.
The guideline sets out ways to put patients with complex health issues at the heart of decisions about their care, including how to decide between different medicines and treatments.
Professor Bruce Guthrie (Professor of primary care medicine at the University of Dundee and chair of the guideline group), said, “The new guideline highlights the need for clinicians to discuss with their patients what the benefits and side effects of drugs or treatments might be. A decision on what treatment is best for the patient, based on their wishes, can then be made – and this could lead to stopping treatment if appropriate.”
A database which summarises the benefits and adverse side-effects of a number of common treatments has been created alongside the new guideline. It will help healthcare professionals work together with their patients to make joint decisions about their care.
The new guideline also recommends developing an individual management plan to help optimise care and treatment in line with the patient’s wishes. The plan will also help the patient prioritise appointments for different conditions and help decide what treatments are appropriate to stop if they offer limited benefit.
- Multimorbidity is the presence of 2 or more long-term health conditions, which can include:
- defined physical and mental health conditions such as diabetes or schizophrenia
- symptom complexes such as frailty or chronic pain
- sensory impairment such as sight or hearing loss
- alcohol and substance misuse.
- The management of risk factors for future disease can be a major treatment burden for people with multimorbidity and should be carefully considered when optimising care.
- The evidence for recommendations in NICE guidance on single health conditions is regularly drawn from people without multimorbidity and taking fewer prescribed regular medicines.
- Think carefully about the risks and benefits, for people with multimorbidity, of individual treatments recommended in guidance for single health conditions. Discuss this with the patient alongside their preferences for care and treatment.
Table: General principles set out in the new NICE guideline (NG 56)
NICE clinical guideline (NG 56). Multimorbidity: clinical assessment and management. https://www.nice.org.uk/guidance/ng56