NICE have done a commendable job addressing perhaps the most challenging aspect of medical practice today. They outline some practical and guiding principles to use when dealing with multimorbidity, though inevitably these raise challenges regarding their implementation – time constraints and communication issues in particular.
Importantly, this guideline is explicit in stating that the application of single condition guidelines without consideration of the wider picture is not appropriate medicine – something every GP knows, as do NICE, though this may not have been the message received over the years.
The inclusion of a database of treatment effects is a critical and valuable component, containing information on the effectiveness of treatments, duration of treatment trials and the populations included in trials – information we need to know to judge the potential benefit of treatments for the person sitting in our consulting room.
The publication of the guideline may turn out to be a significant moment of change in the way we practice and are encouraged to practice, though there’s no doubt it will be an evolving area for years to come.