Multimorbidity: Through a Glass Darkly

Abstract

This chapter firstly provides an overview of multimorbidity as a complicated clinico-epidemiological, yet reductionist construct of multiple discreet disease(s) occurring in one individual. Current multimorbidity studies highlight taxonomic challenges about the actual nature of disease or chronic disease singly or in clusters and their underlying processes, and clinical practices. Multimorbidity is then viewed through the lens of systems medicine in the future, as multi-layered complex adaptive systems health care. Systems medicine is an interdisciplinary field of science which studies the nature and processes of complex systems of the biological sciences, as well as in information technology applied to medicine. Networks and psychoneuroimmunology and social phenomena form another “branch” of systems medicine. Nevertheless, clinico-epidemiological multi-morbidity, systems medicine and psychoneuroimmunology are very far apart in the literature with few intersecting research publications, despite commonality in the use of biomarkers and biometrics. As multimorbidity care will inevitably embrace new knowledge and technologies, it is important to improve personal- and population-centred care, rather than biomarker and biometrics reductionism. Opportunities must be embraced to transcend fragmented silos of knowledge and reductionistic care into integrated systems from biomarkers to clinical and population networks that help improve individual care.