De Soyza Anthony, Goodwin Victoria A, Roberts Kate, Masoli Jane, Mathews Jacqueline, Wilding John, Nestor Gary, Bower Peter
Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.
Ageing and Rehabilitation, University of Exeter, Exeter, UK.
BMJ Open. 2025 Sep 14;15(9):e096206. doi: 10.1136/bmjopen-2024-096206.
The purpose of this article is to share insights from the National Institute for Health and Care Research Clinical Research Network (NIHR CRN) in delivering research for Multiple Long Term Conditions (MLTC) and to highlight lessons of wider relevance across the research ecosystem.
Designing health and care systems to be more responsive to the needs of people living with MLTC requires a considerable evidence base. When compared with research focused on a single disease area, research relating to MLTC raises unique considerations at the stages of planning, placing, and delivering research studies. Our article describes challenges associated with MLTC research outcomes and outlines different types of interventions to target MLTC, along with related research delivery considerations. Our article also raises important considerations for placing research in the most appropriate setting and highlights the vital role of robust feasibility studies, informed by the lived experience of patients and carers with MLTC, for ensuring that studies are conducted, recruited to, and completed in a timely and appropriate way.
Increasing the evidence base for the prevention and management of MLTC is a necessity for our health and care system. This presents novel challenges that require collaboration between multiple stakeholders. The UK benefits from a unique research infrastructure, including support for the stages of planning and delivery of health and care research. As the health and care system moves towards bringing care closer to patients and service users, the appropriate selection of the health and care settings and research sites in which to deliver MLTC research, in addition to understanding and removing barriers to recruitment and participation for people with MLTCs, are important considerations to enable us to collectively respond to this challenge.
本文旨在分享英国国家卫生与保健研究临床研究网络（NIHR CRN）在开展多重长期病症（MLTC）研究方面的见解，并强调在整个研究生态系统中具有更广泛相关性的经验教训。
设计更能响应MLTC患者需求的卫生与保健系统需要大量的证据基础。与专注于单一疾病领域的研究相比，与MLTC相关的研究在研究计划、研究地点安排和研究开展阶段提出了独特的考量因素。我们的文章描述了与MLTC研究结果相关的挑战，概述了针对MLTC的不同类型干预措施以及相关的研究实施考量因素。我们的文章还提出了将研究置于最合适环境中的重要考量因素，并强调了强有力的可行性研究的关键作用，这些研究以MLTC患者及其护理人员的实际生活经验为依据，以确保研究能够及时、适当地进行、招募受试者并完成。
增加MLTC预防和管理的证据基础对我们的卫生与保健系统来说是必要的。这带来了新的挑战，需要多个利益相关者之间的合作。英国受益于独特的研究基础设施，包括对卫生与保健研究计划和实施阶段的支持。随着卫生与保健系统朝着将护理更贴近患者和服务使用者的方向发展，除了理解并消除MLTC患者招募和参与的障碍外，合适地选择开展MLTC研究的卫生与保健环境及研究地点，是使我们能够共同应对这一挑战的重要考量因素。
