International Delphi Study Defines 31 Recommendations for Multimorbidity Care

Managing multiple long-term conditions (MLTC) requires coordinated, patient-centred care, but guidance can be difficult to apply in routine practice. Researchers reviewed 14 guidelines, extracting 297 recommendations and synthesizing them into 65 items for assessment in a modified Delphi study. Experts recruited from 25 countries rated recommendation relevance in two online survey rounds; consensus was defined as at least 70% of respondents assigning a rating of 7 or higher on an 11-point scale.

In the first round, 42 experts (78% response rate) reached consensus on 32 recommendations. In the second, 40 experts (74% response rate) reassessed 11 items and rated four newly formulated recommendations; five recommendations reached consensus. The researchers then refined the results into 31 recommendations across six areas: approach to MLTC care, comprehensive assessment, patient-centred consultation, individualized care planning, monitoring and follow-up, and collaboration and coordination.

The recommendations offer a broadly endorsed framework for clinicians and policymakers designing MLTC care strategies. However, this study assessed perceived relevance, not feasibility, implementation or effects on care quality and patient outcomes. The recommendations therefore require further evaluation before their impact in routine settings can be established.