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Author Archives: Bhautesh Jani

New hosts for the International Research Community on Multimorbidity


By Barbara Nicholl and Bhautesh Jani

After 11 years of hosting the International Research Community on Multimorbidity, the Université de Sherbrooke has passed on the baton to the University of Glasgow. Led by Martin Fortin and colleagues, the website was started as a place to report on multimorbidity research taking place internationally. Since the inception in 2011, with only a small group of members, the international community and the amount of outstanding research in this field has grown dramatically. We want to continue to recognise this by sharing your news and events on multimorbidity research. The blog posts and updates of the library of multimorbidity literature will continue. We will have an archive of past blog posts coming soon and, in the meantime, the Université de Sherbrooke website will remain visible, please see the link on our new website. Please let us know via our email address (multimorbidityblog@glasgow.ac.uk) when you have news to share with this community or if you have ideas for the type of material you would like us to share.

We are very grateful to Martin Fortin and José Almirall-Collazo for sharing their knowledge and tips on the community onto us. Bhautesh Jani and Barbara Nicholl will lead the website at Glasgow and will strive to make it a shared space for the international community to share research activity on multimorbidity. We look forward to seeing some of you at the North American Primary Care Research Group annual meeting in November.
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Middle-aged men with multimorbidity at greatest risk of death

By Bhautesh Jani and Frances Mair

Our study published in BMC Medicine [1], found that multimorbidity is associated with a higher risk of death from cancer, vascular conditions and all causes of death – even after accounting for lifestyle or demographic factors. The effect of multiple long-term conditions (LTCs) on higher mortality risk was largest among men between 37-49 years.

The study used the UK Biobank cohort (approx. half million adults) and found that the type of LTC, as opposed to the number of LTC, may have an important role to play in understanding the relationship between multimorbidity and death.

This is the first study to examine the relationship of multimorbidity with cancer mortality and we have shown a dose-response relationship between number of LTCs and cancer mortality.

Younger participants, especially men, were observed to have a relatively higher risk of mortality with increasing number of LTCs, and that certain combinations of conditions were associated with a particularly higher risk of death. Going forward, further research is needed to study the impact and management of multimorbidity in middle aged adults, as they may be at higher risk of early death.

1. Jani BD, Hanlon P, Nicholl BI, et al. Relationship between multimorbidity, demographic factors and mortality: findings from the UK Biobank cohort. BMC Med 2019;17(1):74. doi: 10.1186/s12916-019-1305-x

Depression Screening and Multimorbidity

By Bhautesh Jani and Frances Mair

Our new paper published in Plos One examines the impact of routine depression screening, using the Hospital Anxiety and Depression Scale (HADS), and its relationship with multimorbidity and chronic disease management. In our study based on more than 125000 patients with chronic disease, the findings highlight the difficulties in implementing depression screening universally in primary care, despite incentivisation. Younger patients and those from deprived socio-economic background were more likely to have a positive result, when screened for depression symptoms. Importantly, depression screening did lead to an increase in the rate of anti-depressant prescribing in patients with chronic disease, which has significant resource implications.

In our study, depression screening was more often undertaken in patients with multimorbidity when compared to those with a single disease. Patients with multimorbidity had a greater chance of having a raised HADS score on depression screening, which resonates with the emerging evidence in this area. The crucial question will be to investigate the effect of depression screening in patients with chronic disease and multimorbidity on clinical outcomes, if any. The next phase of our project aims to address this question.