The importance of multiple conditions for priority conditions

The NHS has often focused resources and attention on single, important conditions such as cancer, cardiovascular and respiratory diseases, and mental health. This focus can achieve improvements in treatment and outcomes for patients, however failing to consider the impact of multiple conditions on patients with these conditions would be a mistake. Our analysis shows that 82% of people with cancer, 92% with cardiovascular disease, 92% with chronic obstructive pulmonary disease (COPD), and 70% with a mental health condition had at least one additional condition (Figure 3). The average number of additional conditions ranged from 1.8 for those with a mental health condition to 3.3 for those with COPD. In other words, for these patients, having multiple conditions is now the norm.

Hypertension and pain were the most common additional conditions in the four clinical conditions we looked at (Figure 4). For example, 40% of people with cancer also had hypertension and over 30% had a painful condition. This may reflect either causation (eg a cancer that causes pain) or the fact that these are common conditions in the population.

Figure 3. Average number of additional conditions for people with cancer, chronic obstructive pulmonary disease, cardiovascular disease, or a mental health condition

Although strategies to improve health care often have a single disease focus, future initiatives might need to consider the person’s additional conditions to reduce their treatment load and improve their outcomes. For example, people with heart disease are at higher risk of dying in the short and medium term if they have depressive symptoms, compared with those who do not. Appropriate treatment for depression might be as important as treatment strategies for heart disease risk factors (and might help patients to adhere to those strategies).

These estimates are based on a total of 4,075 people with cancer, 12,971 people with cardiovascular disease (coronary heart disease, stroke, transient ischemic attack, peripheral vascular disease), 4,890 people with COPD, and 32,792 people with a mental health condition (including depression, anxiety, schizophrenia, anorexia, bulimia, alcohol or other substance misuse) in our sample.

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