Prevention and Management of Multimorbidity in Southeast Asia: A Narrative Review

Xiyu Feng, Haribondhu Sarma, Matthew Kelly
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Abstract

Multimorbidity, the coexistence of two or more chronic conditions, presents a growing global challenge, particularly in low‐ and middle‐income countries such as Southeast Asia. This trend necessitates the development of sustainable integrated care models to prevent and manage multimorbidity effectively. However, progress in this area has been hampered, especially in underdeveloped regions, by various barriers, including the epidemiology of multimorbidity, how to get different specialists and doctors to work together most availably and manage the multiple medication issues and how to develop cost‐effective approaches to reduce the health burden of multimorbidity. Preventive measures in Southeast Asia, which could tackle multiple components which commonly comprise multimorbidity, include enhancing health literacy and health promotion through school‐ and community‐based educational activities, primary healthcare and related policies on employing taxes on tobacco, alcohol and sugary beverages. The social determinants of health‐encompassing poverty and low education may also influence research on multimorbidity. Moreover, stakeholder engagements involving national governments, World Health Organization (WHO) and Association of Southeast Asian Nations (ASEAN) are crucial. Management strategies focus on integrated care models, including patient‐centred primary healthcare, digital healthcare technologies, and medication management to control polypharmacy. Although research on multimorbidity in Southeast Asia is increasing, translating findings into practical measures was limited. Future efforts should prioritize evidence‐based approaches to prevent and manage multimorbidity effectively, addressing challenges like health system focusing on single chronic disease treatment independently, resource limitations, healthcare provider shortages and individual adherence issues. These ways promise to enhance the quality of life and health outcomes in this region.
东南亚多发病的预防和管理:叙述性综述
多病共存是指同时存在两种或两种以上的慢性病,这是一个日益严峻的全球性挑战,尤其是在东南亚等中低收入国家。在这种趋势下,有必要发展可持续的综合护理模式,以有效预防和管理多发病。然而,这一领域的进展一直受到各种障碍的阻碍,尤其是在欠发达地区,这些障碍包括多病流行病学、如何让不同的专家和医生最有效地合作并管理多种用药问题,以及如何制定具有成本效益的方法来减轻多病带来的健康负担。东南亚的预防措施可以解决通常由多种因素构成的多病问题,包括通过学校和社区的教育活动、初级医疗保健以及对烟草、酒精和含糖饮料征税的相关政策来提高健康素养和促进健康。健康的社会决定因素--包括贫困和教育水平低,也可能影响多病症的研究。此外,国家政府、世界卫生组织(WHO)和东南亚国家联盟(ASEAN)等利益相关方的参与也至关重要。管理策略侧重于综合护理模式,包括以患者为中心的初级医疗保健、数字医疗保健技术和药物管理,以控制多种药物的使用。虽然东南亚有关多药并发症的研究在不断增加,但将研究结果转化为实际措施的工作却很有限。未来的工作应优先考虑以证据为基础的方法,有效预防和管理多药并发症,应对医疗系统独立关注单一慢性病治疗、资源限制、医疗服务提供者短缺和个人依从性问题等挑战。这些方法有望提高该地区的生活质量和健康水平。
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