More than one condition, one patient, one opportunity for better care
Imagine visiting a primary healthcare clinic because your blood pressure has been difficult to control. During the consultation, you also mention poor sleep, persistent tiredness, and losing interest in activities you once enjoyed. While your blood pressure receives attention, your emotional wellbeing may go unnoticed.
This is one of the challenges faced by people living with cardiometabolic and mental health multimorbidity – the presence of cardiometabolic and mental health conditions in the same person.
What is multimorbidity?
Multimorbidity refers to having two or more long-term health conditions. Cardiometabolic conditions include hypertension, type 2 diabetes, obesity, heart disease, and stroke, while common mental health conditions include depression and anxiety.
These conditions can influence and reinforce one another. Depression, for example, may affect medication adherence, healthy eating, physical activity, and attendance at clinic appointments. At the same time, living with a chronic condition can increase psychological distress and the risk of depression or anxiety.
The result can be a cycle in which both physical and mental health become harder to manage.
Why does it matter?
Across Ghana, Kenya, Uganda, and other low- and middle-income countries, health systems are responding to changing patterns of disease, including a growing burden of non-communicable diseases and mental health conditions.
Yet healthcare is often organised around individual diseases. Patients, however, experience their health as a whole. Multimorbidity can affect quality of life, treatment adherence, daily functioning, and families who provide emotional, practical, and financial support.
Why primary care is central
Primary care is often where people first seek healthcare and receive ongoing management of chronic conditions. It is therefore an important setting for identifying and addressing multimorbidity.
Integrated care brings physical and mental healthcare closer together, supports coordinated care plans, strengthens self-management, and promotes continuity of care. Most importantly, it places the person – not the individual disease – at the centre of care.
How M-CARE is contributing
The M-CARE Project is addressing cardiometabolic and mental health multimorbidity in primary care settings across Ghana, Kenya, and Uganda. Through collaboration among researchers, healthcare professionals, policymakers, implementation scientists, and communities, the project aims to develop and evaluate approaches that can strengthen integrated care.
A key focus is implementation science: understanding not only whether an intervention works, but whether it can be delivered effectively, accepted by patients and providers, sustained by health systems, and scaled in real-world settings.
Looking ahead
Better primary healthcare requires us to see the whole person, not just individual diagnoses. By bringing cardiometabolic and mental health care together, M-CARE seeks to contribute to more coordinated, responsive, and equitable health systems.
At M-CARE, we believe that better evidence can lead to better care – and that better care begins with recognising the connection between physical and mental health.
For more information about M-CARE, our research, activities, and latest updates, visit our website (https://www.mcareproject.org/) and follow us on our various social media platforms.
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