Comparing national multimorbidity policies and guidelines

CaHRU_logotypePeople living with a long-term condition often have more than one condition to contend with. This is known as ‘multimorbidity’, commonly defined as the co-occurrence of two or more chronic conditions within one person. In this situation it is important that the person, not the disease, is the focus. Policies referring to multimorbidity are considered a crucial element in safe health systems.

NadeekaChandraratneThe CaHRU team of Dr Nadeeka Chandraratne and Dr Ravindra Pathirathna, international visiting fellows attached to CaHRU from the Postgraduate Institute of Medicine at the University of Colombo, Sri Lanka, together with Prof Niro Siriwardena and Dr Christopher Harrison from the University of Sydney conducted a content analysis of policy documents and guidelines on multimorbidity from the UK, Australia and Sri Lanka. Despite considerable differences in healthcare structure and financing, all three countries face the challenge of multimorbidity. An understanding of how each country is addressing this challenge was considered important for identifying policy initiatives, gaps and opportunities for further improvement.

RavindraPathirathneThe article describing the study and its findings, ‘A comparison of policies and guidelines related to multimorbidity in the UK, Australia and Sri Lanka‘, was published this month in the first issue of the Australian Journal of General Practice 2018 with an accompanying editorial on Multimorbidity written by Niro Siriwardena and Christopher Harrison.

The team found overall a lack of health policy and guidance for multimorbidity: the guideline ‘Multimorbidity: Clinical assessment and management’ from The National Institute for Health and Care Excellence (NICE), UK was the only specific guideline on multimorbidity. Australia and Sri Lanka lack specific national documents addressing multimorbidity. The promising features observed in Australia were policies that are directly concerned with the health of socially disadvantaged groups, which are at higher risk of multimorbidity. Policies in Sri Lanka were more concerned with preventing chronic conditions, and on community mobilisation and empowerment.

lilyThe paper highlights that Sri Lanka needs to focus on policies that emphasise integration and patient-centred healthcare delivery for people with multimorbidity, whereas in the UK and Australia, policies on community-based approaches to address determinants of multimorbidity are needed.

By Dr. Nadeeka Chandraratne

Dr Pradeep Ratnasekare joins CaHRU as an international visiting fellow

sigiriya2Dr Pradeep Ratnasekare joined CaHRU this January 2018 as our third international visiting fellow from the University of Colombo’s Postgraduate Institute of Medicine. Pradeep graduated as a bachelor of Medicine and bachelor of Surgery in 1996 from the faculty of Medicine, University of Ruhuna and then completed postgraduate studies at the University of Colombo, Sri Lanka, in the fields of respiratory medicine and then in medical administration where he gained his master’s in 2011 and MD in 2016.

davHe has worked for over four years as a primary care medical officer, and six years as a medical officer in respiratory medicine, health system manager and health care researcher. As a health system manager he developed experience in various fields of hospital and public health programme management. He has worked as a hospital director in many secondary and tertiary care hospitals in Sri Lanka and worked as deputy director of the Medical Research Institute, the premier national level reference and referral medical laboratory and medical research centre for public and private sectors in Sri Lanka for last 18 months. His main interests are in health technology assessment and management, modern hospital planning and architecture, health system research and quality improvement in health care. Pradeep has several publications into his credit in the Journal of Medical Administrators Sri Lanka and Sri-Lanka journal of Health Policy and Management mainly on interventions carried out to improve health systems. He is a member of several academic associations in Sri Lanka including the College of Medical Administrators of Sri Lanka and Sri Lanka Medical Association. He is a member of research evaluation committee of the Medical Research Institute.

lilypondWhile at CaHRU he plans to: study the prehospital care system in the UK with a view to adapting it to develop a suitable model for Sri Lanka; to study the primary health care system in the UK National Health Service (NHS) of United Kingdom with respect to quality improvement and clinical governance; to study the systems and methods in place for Health Technology Assessment (HTA) and Health Technology planning in the United Kingdom; to learn about hospital design and planning; and to actively contribute to CaHRU’s research programme in primary and prehospital care. Listening to classical music, singing and playing cricket are his favourite hobbies.