Managing complex long-term conditions (LTC) and multi-morbidity


  • Archana Dhere Specialty Registrar (ST6) in Diabetes & Endocrinology, Wycombe General Hospital, Buckinghamshire Healthcare NHS Trust, Queen Alexandra Rd, High Wycombe HP11 2TT



Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross- sectional study. Lancet 2012;380:37-43. 60240-2

Royal College of Physicians (RCP). Hospitals on the edge? The time for action. London: RCP, 2012.

Future Hospital Commission. Future hospital: caring for medical patients. A report from the Future Hospital Commission to the Royal College of Physicians. London: RCP, 2013.

Shape of training: Securing the future of excellent patient care, Final report to Royal College of Physicians. London: RCP, 2013.

Suissa S, Dell'Aniello S, Ernst P. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax 2012;67:957-63.

McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2015; (2):CD003793.

van Manen J, Bindels P, IJzermans C, van der Zee JS, Bottema BJ, Schadé E. Prevalence of comorbidity in patients with a chronic airway obstruction and controls over the age of 40. J Clin Epidemiol 2001;54:287-93.

Greening N, Evans R, Williams J, Green RH, Singh SJ, Steiner MC. Does body mass index influence the outcomes of a Waking-based pulmonary rehabilitation programme in COPD? Chronic Respir Dis 2012;9:99-106.

Evans R, Singh S, Collier R, Loke I, Steiner MC, Morgan MD. Generic, symptom based, exercise rehabilitation; integrating patients with COPD and heart failure. Respir Med 2010;104:1473-81.

Kruis A, Smidt N, Assendelft W, et al. Cochrane corner: is integrated disease management for patients with COPD effective? Thorax 2014;69:1053-5. http://dx/

Curtis J, Westfall A, Allison J, et al. Population-based assessment of adverse events associated with long-term glucocorticoid use. Arthritis Rheum 2006;55:420-6.

The British Geriatrics Society in association with the Royal College of General Practitioners and Age UK. Consensus Best Practice Guidance for the care of older people living with frailty in community and outpatient settings. London, 2014.

Sinclair A, Hillson R, Bayer A. Diabetes and dementia in older people: a Best Clinical Practice Statement by a multidisciplinary National Expert Working Group. Diabet Med 2014;31: 1024-31. http://dx.dor/org/0.1111/dme. 12467

Sinclair A, Dunning T, Rodriguez-Mañas L. Diabetes in older people: new insights and remaining challenges. Lancet Diabetes Endocrinol 2015;3:275-85.

Hahr A, Molitch M. Management of diabetes mellitus in patients with chronic kidney disease. Clin Diabetes Endocrinol 2015;1.

Kidney Disease Improving Global Outcomes (KDIGO). Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2013;3:1-163.

National Heart Failure Audit report 2013-2014. accessed 3 May 2016).

van Deursen V, Urso R, Laroche C, et al. Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey. Eur J Heart Fail 2013;16:103-11.

Smith D, Langan J, McLean G, Guthrie B, Mercer S. Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study. BMJ Open 2013;3:e002808.

Laursen T, Nordentoft M, Mortensen P. Excess early mortality in schizophrenia. Ann Rev Clin Psychol 2014;10:425-48.

Burn D. UK Parkinson's Excellence Network: empowering service improvement across the UK. Neurodegener Dis Manage 2015;5:173-6.






Meeting Reports