We have a problem. More and more people are living with several medical conditions, sometimes many.
But medical education and training, delivery, guidelines and even research, focus on one disease at a time. There’s a mismatch between what patients experience and what doctors are trained to do.
Researchers at University College London (UCL) are approaching this dilemma by identifying patterns of common diseases occurring together in the same people, using data from four million English patients.
As a result, the Academy of Medical Sciences and the UK’s Chief Medical Officer are now investigating which diseases co-occur in the same people and why.
From routine health records the team identified clusters of 308 common mental and physical conditions in men and women of different ages and different ethnicities.
It found heart failure often occurs along with high blood pressure, angina, heart attack, atrial fibrillation, type 2 diabetes, chronic obstructive pulmonary disease, chronic kidney disease, and osteoarthritis (co-morbidities). Hypertension, on the other hand, was most strongly associated with obesity, type 2 diabetes and high blood fats in people aged 40 years and older.
Breast cancer was linked to different comorbidities in people from different ethnicities, asthma with different comorbidities between the sexes, and bipolar disorder with different comorbidities in younger people compared with older ones, so it is dependent on age.
Researchers say this clustering should help improve health in English patients with more than one illness.
UCL study co-author Professor Aroon Hingorani said: “Information from minority ethnic groups and younger people has often been missing from studies of multimorbidity, but by using diverse electronic health records, we present a more inclusive perspective. This is one area where the NHS electronic health records and data science can generate important insights.”
Professor Spiros Denaxas, also at UCL added: “Millions live with multiple diseases, yet our understanding of how and when these transpire is limited. This project is the first step towards understanding how these diseases co-occur and identifying how to best treat them.”
It should become possible to pick up diseases that cluster more commonly than expected by chance, and thus provide an entry point to investigate common risk factors and treatments.
The findings should also help patients better understand their illness, doctors plan management, health-care providers optimise service delivery, policymakers plan resource allocation, and researchers to develop new or use existing medicines to treat several diseases together. Good news.
