National Institute for Health and Clinical Excellence (NICE)
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Tailored care needed for people with more than one complex health condition

NICE calls for a tailored approach to care when treating someone who has two or more long-term health conditions.

Aimed at healthcare professionals, GPs and physicians, a new NICE guideline sets out ways to put patients with complex health issues at the heart of decisions about their care, including how to decide between different medicines and treatments. 

Professor Bruce Guthrie, professor of primary care medicine at the University of Dundee and chair of the guideline group, said: “The number of people with many long-term health conditions is set to rise. It can be really difficult to care for these patients because the conditions they have and their treatments can interact causing unwanted side effects.” 

A database which summarises the benefits and adverse side effects of a number of common treatments has been created alongside the new guideline. It will help healthcare professionals work together with their patients to make joint decisions about their care. 

Prof Guthrie said: “The new guideline highlights the need for clinicians to discuss with their patients what the benefits and side effects of drugs or treatments might be. A decision on what treatment is best for the patient, based on their wishes, can then be made – and this could lead to stopping treatment if appropriate.” 

Caring for more people with multiple health conditions, coupled with an ageing population, could require £5 billion in additional expenditure by 2018, according to a 2012 report by the Department of Health

Professor David Oliver, clinical vice president of the Royal College of Physicians, said: “People living with multiple long-term conditions can experience significant problems from treatments they receive. Treatment is often given for individual conditions without consideration of effects on a different condition the person might have. 

“All patients have a right to be supported by doctors to make informed decisions about their own care. It is important that doctors talk to patients to learn what they want from their care and tailor treatments towards meeting those priorities and goals. This is particularly important with older, frail people where the risks and benefits of treatment may need careful consideration.” 

The new guideline also recommends developing an individual management plan to help optimise care and treatment in line with the patient’s wishes. The plan will also help the patient prioritise appointments for different conditions and help decide what treatments are appropriate to stop if they offer limited benefit. 

Professor Mark Baker, director of the centre for guidelines at NICE, said: “Our guideline brings an important perspective to light – that it’s our responsibility as health care professionals to deliver person-centred care, not disease-focused treatment. 

“We have set out recommendations and developed tools to help clinicians work together with their patients to establish what’s important. Giving tailored care will make a real difference to how a patient can manage their conditions in their daily lives.”

 

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