Multimorbidity, the coexistence of multiple long-term conditions (MLTC-M), is a growing global health concern. It significantly impacts quality of life, leads to longer hospital stays, and increases mortality rates. However, the lived experiences of individuals coping with the burden associated with MLTC-M remain under-researched. To address this gap, researchers initiated the creation of two electronic cohorts: the SAIL MELD-B e-cohort (SMC) and the SAIL MELD-B Children and Young Adult e-cohort (SMYC). These resources aim to enhance our understanding of how the burden of MLTC-M affects individuals, identify new clusters of burdensome MLTC-M, and explore the key early-life risk factors that contribute to this burden. Additionally, the cohorts will help model prevention scenarios, informing public health interventions and policies.
We spoke to Research Officer and Data Scientist Dr. Roberta Chiovoloni at Population Data Science, Swansea University, to learn more about this research.
Why This Research Matters
The prevalence of MLTC-M is escalating, especially among older adults. Beyond its clinical implications, MLTC-M imposes a “burden” on daily living that is often overlooked in traditional research. This includes challenges in accessing healthcare, managing complex treatment regimens, and maintaining overall well-being. Existing studies primarily focus on the clustering of conditions and associated risk factors but fail to capture the holistic impact on individuals’ lives. The MELD-B project addresses this shortfall by:
- Investigating how the burden of MLTC-M varies across age groups and socioeconomic strata.
- Exploring its progression over time to identify critical intervention points.
Research Aims
The project’s core objectives include:
- Building Two Robust E-Cohorts:
- The SMC and SMYC cohorts are designed as comprehensive, research-ready data assets. They integrate anonymised demographic, administrative, and electronic health record (EHR) data.
- Developing a Reproducible Data Pipeline:
- This pipeline ensures efficient updates and management of data, enabling the continuous publication of refreshed dataset versions. Such a system allows seamless integration of new health events and cohort updates.
- Enabling Advanced Analytical Techniques:
- The cohorts facilitate clustering, sequencing, and statistical analysis to uncover patterns and identify pivotal moments for intervention.
The Use of SAIL Databank
The SAIL Databank, a trusted resource for anonymised linked data, was instrumental in constructing the SMC and SMYC cohorts. The researchers:
- Analysed records of over five million individuals registered with general practitioners in Wales since 2000.
- Extracted year-by-year sociodemographic and residential data to build a comprehensive population overview.
- Linked demographic data with health events from primary and secondary care to derive descriptive insights into the burden of MLTC-M.
This meticulous approach ensures a nuanced understanding of multimorbidity’s impact on diverse populations.
Anticipated Impact
The establishment of the SMC and SMYC cohorts marks a significant milestone in multimorbidity research. These data assets and the reproducible pipeline:
- Enable dynamic and up-to-date analyses.
- Support the identification of critical time-points for public health interventions.
- Provide a sustainable framework for future research on multimorbidity and health outcomes.
By addressing gaps in current knowledge, the MELD-B project paves the way for innovative strategies to alleviate the burden of MLTC-M on individuals and healthcare systems alike.
Funding and Collaborations
This research is supported by the National Institute for Health and Care Research (NIHR) Artificial Intelligence in Multiple Long-Term Conditions (AIM) Programme (award identifier: NIHR203988). The project also benefits from collaborations with researchers at the University of Southampton, ensuring a multidisciplinary approach to tackling multimorbidity.
Learn more about this research here.