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AI to improve treatments for people with multiple long-term conditions

The NIHR has awarded £2.5 million for new artificial intelligence (AI) research led by the University of Birmingham. The study will use AI to produce computer programmes and tools to help doctors improve the choice of drugs for patients with clusters of multiple long-term conditions.

Called the OPTIMAL study (OPTIMising therapies, discovering therapeutic targets and AI assisted clinical management for patients Living with complex multimorbidity), the research aims to understand how different combinations of long-term conditions – and the medicines taken for these diseases – interact over time to worsen or improve a patient’s health.

The study will be led by Dr Thomas Jackson and Professor Krish Nirantharakumar at the University of Birmingham and carried out in collaboration with the University of ManchesterUniversity Hospitals Birmingham NHS Foundation TrustNHS Greater Glasgow & ClydeUniversity of St Andrews,and the Medicines and Healthcare Products Regulatory Agency. Both the University of Birmingham and University Hospitals Birmingham are founding members of BHP.

An estimated 14 million people in England are living with two or more long-term conditions, with two-thirds of adults aged over 65 expected to be living with multiple long-term conditions by 2035.

Dr Thomas Jackson, Associate Professor in Geriatric Medicine at the University of Birmingham, said: “Currently, when people have multiple long-term conditions, we treat each disease separately. This means we prescribe a different drug for each condition, which may not help people with complex multimorbidity, which is a term we use when patients have four or more long-term health problems.

“A drug for one disease can make another disease worse or better, however, presently we do not have information on the effect of one drug on a second disease. This means doctors do not have enough information to know which drug to prescribe to people with complex multimorbidity.”

Krish Nirantharakumar, Professor in Health Data Science and Public Health at the University of Birmingham, added: “Through our research, we can group such people based on their mixes of disease. Then we can study the effects of a drug on each disease mix. This should help doctors prescribe better and reduce the number of drugs patients need. This will lead to changes in healthcare policy which would benefit most people with complex multimorbidity.”

The research is one of a number of studies being funded by the NIHR’s Artificial Intelligence for Multiple Long-Term Conditions (AIM) call, which is aligned to the aims of the NHSX AI Lab, that combine data science and AI methods with health, care and social science expertise to identify new clusters of disease and understand how multiple long-term conditions develop over the life course.

The call will fund up to £23 million of research in two waves, supporting a pipeline of research and capacity building in multiple long-term conditions research. The first wave has invested nearly £12 million into three Research Collaborations, nine Development Awards and a Research Support Facility, including the University of Birmingham-led study.

Improving the lives of people with multiple long-term conditions and their carers through research is an area of strategic focus for the NIHR, with its ambitions set out in its NIHR Strategic Framework for Multiple Long-Term Conditions Research.

Professor Lucy Chappell, NIHR Chief Executive and chair of the AIM funding committee, said: “This large-scale investment in research will improve our understanding of clusters of multiple long-term conditions, including how they develop over a person’s lifetime.

“Over time, findings from this new research will point to solutions that might prevent or slow down the development of further conditions over time. We will also look at how we shape treatment and care to meet the needs of people with multiple long-term conditions and carers.”

To date NIHR has invested £11million into research on multiple long-term conditions through two calls in partnership with the Medical Research Council, offering both pump-priming funds and funding to tackle multimorbidity at scale.