Interventions for the prevention and management of cardiometabolic multiple long-term conditions.

Abstract

Multiple long-term conditions (MLTC or multimorbidity) are increasing in global prevalence and represent a growing burden for individuals and health-care systems. Grouping cardiometabolic MLTC can be justified because aetiological antecedents and risk factors are often shared, and similar therapeutic approaches can have positive effects on the prevention, treatment, and delayed progression of many of the constituent conditions. In this Series paper, we focus on interventions for the prevention and management of cardiometabolic MLTC, under the broad headings of population-level, individual-level, and system-level interventions. Population-level public health measures such as educational, fiscal, regulatory, and environmental policies, and population-level screening and early detection can result in improved risk factor identification and control, although evidence that they reduce incidence and progression of cardiometabolic MLTC is more scarce. At an individual level, lifestyle interventions and pharmacotherapeutics can reduce the incidence and progression of cardiometabolic MLTC and provide effective treatment. Together with pharmacotherapeutic strategies, approaches to improve medicines management could help to optimise clinical outcomes in those living with cardiometabolic MLTC. System-level solutions, including integrated models of care and care continuity, provide opportunities to better address the holistic needs of people living with cardiometabolic MLTC. Together, combinations of multilevel approaches are required.