MLTC-M Community of Practice in Clinical Context and Pathways (Clinical Community of Practice)

Lead Research Organisation: UNIVERSITY OF EXETER
Department Name: Institute of Health Research


People tend to accumulate health problems and diagnoses. When several long-term health problems or diagnoses co-exist it is called multimorbidity. Our research is funded by the Strategic Priorities Fund as multimorbidity is now recognised as a huge problem in the UK and across the world. Traditionally, clinical research has focussed on one health condition, and often people with several diagnoses, or multimorbidity, have been excluded from research studies. We are asking for funding to work together between the research groups on multimorbidity.
We aim to create a Community of Practice for clinicians (doctors, nurses, pharmacists, physiotherapists or from any clinical background) working on multimorbidity research. This clinical "Community of Practice" (CoP) will provide an opportunity for clinicians researching multimorbidity in separate research groups to meet each other, learn, share ideas and come up with new ideas together to form future research.
The clinical CoP will be focussed around an online platform, where we can interact with each other and form groups with specific focuses. For example, some health problems can be diagnosed without question - such as heart attack or stroke - while others are more complicated to define, such as mental health conditions, pain or incontinence. Even more complicated is linking different health problems into clusters. These smaller groups might focus on these complex areas. We will run a face-to-face launch event and work together to see what the priorities should be - we want to make sure that we work effectively to overcome the biggest challenges. After that, we will communicate with our members on the online platform (which we hope to develop with other clinical researchers in multimorbidity, via the National Institute of Health Research (NIHR)), on social media via a specific hashtag, and by a monthly newsletter. Our core group of investigators will meet every 3 months. 6 virtual workshops will be run on key topics. We will make sure that we talk to other funded CoPs to see if we can work together on specific topics to combine our clinical skills with their skills: for example with the proposed Statistical Methods CoP and Patient and Public Involvement and Engagement. We will conduct a survey via our networks to try to understand what clinicians think are the key priorities for multimorbidity research, which we will write up for publication and which is likely to lead on to other work in this area.
The CoP will support the communication of this multimorbidity research to clinicians, and help to increase multimorbidity research and research delivery capacity. We will host symposiums, and already have agreement in principle from key partners in primary care and geriatric medicine to feature CoP research in their conferences. We will also host an event towards the end of the CoP funding as a clinical showcase to a wider clinical audience and other interested people.
A further key way in which the clinical CoP can support multimorbidity work is to consider the next steps in this research and how we can move towards patient benefit. We anticipate that this will be the focus of a working group, a virtual workshop and a writing group to work together on future funding proposals. We have the support of the NIHR Clinical Research Network leads in Primary Care and Ageing, who have told us that they fully support this clinical CoP as it will facilitate early communication about planning future research.
Overall, this clinical CoP aims to accelerate progress in multimorbidity research, while ensuring that it is clinically relevant, train and enthuse clinicians to work and lead multimorbidity research and plan pathways to patient impact. By working with key partners, developing a sustainable online platform for the wider multimorbidity research community and development of future funding proposals this clinical CoP legacy will outlast the funding.

Technical Summary

This clinical Community of Practice (CoP) will enable meaningful networking and collaboration between clinician researchers working with multiple long-term conditions/multimorbidity (MLTC-M) and aid dissemination and pathways to impact. The clinical CoP is flexible to address the clinical challenges of the MLTC-M Research Collaboratives. We have initiated dialogue with the NIHR Clinical Research Network (CRN) project on MLTC-M, and plan to develop an online platform with NIHR Learn to support online networking and communication for clinicians in MLTC-M. A monthly newsletter will include professional development opportunities and events, and a specific hashtag will facilitate social media connections. The clinical CoP will host two face-to-face events: a launch event, to co-develop initial priorities with members and a clinical showcase for cross-Collaborative presentations. Between these events we will host 3 symposiums of cross-Collaborative research tailored to specific conferences, eg. the British Geriatrics Society and the Society of Academic Primary Care, from whom we have support in principle. We will conduct a survey to understand clinicians' key priorities for MLTC-M research, which we anticipate will be published and further developed to form a Delphi exercise through writing groups for external funding. We will organise 6 online workshops, focussed on priorities established by CoP members, working synergistically and responsively with other CoPs. These might include complex phenotypes or disease clusters and pathways to impact. We will support the formation of topic-specific working groups, which may overlap in content and timing with these workshops, and writing groups to co-develop external grant applications, for example on patient-focussed pathways to impact. The platform and community will outlast the funded CoP through stakeholder partnership, engagement with the wider MLTC-M clinical research community and collaborative funding bids.


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Masoli J (2022) Genomics and multimorbidity in Age and Ageing

Description Appointment to Regional MLTC CRN lead
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
Description MLTC 
Organisation Society for Academic Primary Care
Country United Kingdom 
Sector Academic/University 
PI Contribution Building network nationally of MLTC across primary and secondary care Working towards joint material with the MLTC specialist interest group at the society for academic primary care
Collaborator Contribution working synergistically towards improved training in research and for clinicians on MLTC
Impact in progress
Start Year 2023
Description MLTC communities of practice 
Organisation University of Leicester
Country United Kingdom 
Sector Academic/University 
PI Contribution Aligned work with statistical community of practice in MLTC, PPIE community of practice in PPIE and qualitative community of practice in PPIE. Shared dissemination opportunities and collaborative events planned.
Collaborator Contribution as above
Impact Symposiae planned jointly to disseminate work on MLTC - led by clinical community of practice embedded in British Geriatrics Society and European Geriatrics Society conference Shared ECR events
Start Year 2022
Description NIHR Clinical Research Network 
Organisation National Institute for Health Research
Department NIHR Clinical Research Network (CRN)
Country United Kingdom 
Sector Academic/University 
PI Contribution pathways connecting mechanistic research with clinical delivery of MLTC research profile building MLTC research education on MLTC across the CRN
Collaborator Contribution pathway to translational research
Impact Paper in preparation
Start Year 2023
Description Society for academic primary care 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact 20 researchers and PPI leads attended a workshop on MLTC at the Society for Academic Primary Care: Overcoming challenges and facilitating research in Multiple Long-Term Conditions
To identify challenges in research in Multiple Long-Term Conditions (MLTC) and develop goals for resources to facilitate MLTC research
Intended outcome:
To identify challenges and barriers to MLTC research experienced/anticipated by SAPC workshop attendees
To develop key components to inform development of resources to facilitate and support the growth of research in MLTC

This has generated goals for training resources and a collaboration with the SAPC special interest group in MLTC
Year(s) Of Engagement Activity 2023
Description Symposium at British Geriatrics Society Conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact British Geriatric Society MLTC Symposium
Nested conference presentation symposium curated to enable collaboratives from funded MLTC to present work to clinical facing audience in ageing
Year(s) Of Engagement Activity 2023