12th May 2017, Volume 130 Number 1455

Louise Signal, Kelly Semper, Jeannine Stairmand, Cheryl Davies, Elinor Millar, Tony Dowell, Ross Lawrenson, Dee Mangin, Diana Sarfati

Multimorbidity, the coexistence of two or more health conditions,1 is a common and growing problem worldwide.2 While the risk of multimorbidity is higher in those aged 65 years and older,…

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Living with multimorbidity (two or more long-term health conditions) is becoming more common in both young and older New Zealanders. It disrupts people’s 'normal' lives, posing challenges for many, yet people learn to cope by making changes to much of what they do (eg, eating, activity and employment). Dealing with the health care system for those with multimorbidity can be challenging and people value simple things like good communication and receiving care that is effective and respectful even when they are from a different cultural background to that of their health care provider. Health care system support is needed to help people with multimorbidity manage the challenge of dealing with multiple medications using simple aids such as blister packs. Improvements to the health care system are needed to better serve those people living with multimorbidity, their support people and health care providers, eg, longer consultation times with GP/primary care providers to discuss multiple health issues and medications.



Multimorbidity is common, yet there are major gaps in research, particularly among younger and indigenous populations. This research aimed to understand patients’ perspectives of living with multimorbidity.


A qualitative study of 61 people living with multimorbidity, 27 of whom were Māori and a third aged under 65, from urban and rural regions in New Zealand. Six focus groups and 14 interviews were conducted, recorded, transcribed and analysed.


For many participants, living with multimorbidity disrupted their ‘normal’ lives, posing challenges in everyday activities such as eating and toileting, working and managing medications. Dealing with the health system posed challenges such as accessing appointments and having enough time in consultations. Cultural competency, good communication and continuity of care from healthcare providers were all valued. Participants had many recommendations to improve management, including a professional single point of contact to coordinate all specialist care.


Living with multimorbidity is often challenging requiring people to manage their conditions while continuing to live their lives. This research suggests changes are needed in the health system in New Zealand and elsewhere to better manage multimorbidity thus improving patient’s lives and reducing costs to the health sector and wider society.

Author Information

Louise Signal, Cancer and Chronic Conditions (C3) Research Group, University of Otago, Wellington; Kelly Semper,Cancer and Chronic Conditions (C3) Research Group, University of Otago, Wellington; Jeannine Stairmand, Cancer and Chronic Conditions (C3) Research Group, University of Otago, Wellington; Cheryl Davies, Tu Kotahi Asthma Trust, Lower Hutt; Elinor Millar, Cancer and Chronic Conditions (C3) Research Group, University of Otago, Wellington; Tony Dowell, Department of Primary Healthcare and General Practice, University of Otago, Wellington; Ross Lawrenson, Waikato Clinical School, University of Auckland, Hamilton; Dee Mangin, Department of General Practice, University of Otago, Christchurch; Diana Sarfati, Cancer and Chronic Conditions (C3) Research Group, University of Otago, Wellington.


The authors would like to acknowledge the participants and thank them for their generosity in sharing their stories to assist others. We would also like to thank our clinical and community advisors. This research was funded by the Health Research Council of New Zealand, Grant No. 14/173.


Associate Professor Louise Signal, Cancer Control and Screening Unit, Department of Public Health, University of Otago, Mein St, Newtown, Wellington 6021.

Correspondence Email


Competing Interests

Dr Lawrenson is an employee of the University of Waikato and Waikato District Health Board; Dr Sarfati reports grants from the Health Research Council during the conduct of the study.


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