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Background: It is particularly difficult for healthcare providers to deliver optimal medical care to multimorbid middle-aged persons because patients' professional activities, family lives, and other everyday responsibilities hinder them from making necessary lifestyle changes. Our aim was to find out how patients and healthcare providers view and manage the problems of dealing with multimorbidity in middle age., Methods and Findings: This qualitative study consisted of three steps. First, we conducted semi-structured in-depth interviews with 15 purposively sampled middle-aged persons living with multimorbidity to explore the experiences of care in the context of their leisure time, family lives, and work. Second, further individual interviews were carried out to find out the views of 14 healthcare providers. Third, the results of the interviews with patients and healthcare providers were presented to and discussed with four healthcare providers at an interprofessional workshop. Interview data was coded using an inductive-deductive approach and analyzed using content analysis. While patients reflected on challenges in several life domains, healthcare providers differentiated between levels of challenges. Both shared recommendations for better care including i) helping patients cope, ii) providing relief in activities of daily living, iii) continuity of care, iv) interprofessional cooperation, v) health promotion/prevention, vi) expansion of health services and vii) general system-level changes. Furthermore, the healthcare provider workshop highlighted the importance of increasing patient-centeredness, reducing complexity through a care coordinator and promoting interprofessional cooperation/networking., Conclusions: To further improve the care of patients living with multimorbidity, barriers to managing multiple chronic conditions and facilitators to navigating complex care scenarios should be explored not only for people beyond working age, but for individuals in their mid-life specifically., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Dinh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Multimorbidity is of an increasing importance for the health of both children and adults but research has hitherto focused on adult multimorbidity. Hence, public awareness, practice, and policy lack vital information about multimorbidity in childhood and adolescence. We convened an international and interdisciplinary group of experts from six nations to identify key priorities supported by published evidence to strengthen research for children and adolescent with multimorbidity. Future research is encouraged (1) to develop a conceptual framework to capture unique aspects of child and adolescent multimorbidity-including definitions, characteristic patterns of conditions for different age groups, its dynamic nature through childhood and adolescence, and understanding of severity and trajectories for different clusters of multiple chronic conditions, (2) to define new indices to classify the presence of multimorbidity in children and adolescents, (3) to improve the availability and linkage of data across countries, (4) to synthesize evidence on the global phenomenon of multimorbidity in childhood and adolescence and health inequalities, and (5) to involve children and adolescents in research relevant to their health., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: Multimorbidity is the simultaneous occurrence of several (chronic) diseases. Persons living with multimorbidity not only have complex care needs, but the burden of care often has a negative impact on their family lives, leisure time and professional activities. The aim of this project is to systematically review the literature to assess how multimorbidity affects the everyday lives of middle-aged persons, and to find out what abilities and resources help in the development of coping strategies to overcome the challenges of living with it., Methods and Analysis: We will systematically search for studies reporting on the everyday life experiences of middle-aged persons (30-60 years) with multimorbidity (≥2 chronic conditions) in MEDLINE, CINAHL, PsycINFO, Social Sciences Citation Index, Social Sciences Citation Index Expanded, PSYNDEX and The Cochrane Library from inception. We will include all primary studies that use quantitative, qualitative and mixed methodologies, irrespective of publication date/study setting.Two independent reviewers will screen titles/abstracts/full texts, extract data from the selected studies and present evidence in terms of study/population characteristics, data collection method and the phenomenon of interest, that is, everyday life experiences of middle-aged persons with multimorbidity. Risk of bias will be independently assessed by two reviewers using the Mixed Methods Appraisal Tool. We will use a convergent integrated approach on qualitative/quantitative studies, whereby information will be synthesised narratively and, if possible, quantitatively., Ethics and Dissemination: Ethical approval is not required due to the nature of the proposed systematic review. Results from this research will be disseminated at relevant (inter)national conferences and via publication in peer-reviewed journals., Prospero Registration Number: CRD42021226699., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The healthcare burden of patients with multimorbidity may negatively affect their family lives, leisure time and professional activities. This mixed methods systematic review synthesizes studies to assess how multimorbidity affects the everyday lives of middle-aged persons, and identifies skills and resources that may help them overcome that burden. Two independent reviewers screened title/abstracts/full texts in seven databases, extracted data and used the Mixed Methods Appraisal Tool (MMAT) to assess risk of bias (RoB). We synthesized findings from 44 studies (49,519 patients) narratively and, where possible, quantitatively. Over half the studies provided insufficient information to assess representativeness or response bias. Two studies assessed global functioning, 15 examined physical functioning, 18 psychosocial functioning and 28 work functioning. Nineteen studies explored skills and resources that help people cope with multimorbidity. Middle-aged persons with multimorbidity have greater impairment in global, physical and psychosocial functioning, as well as lower employment rates and work productivity, than those without. Certain skills and resources help them cope with their everyday lives. To provide holistic and dynamic health care plans that meet the needs of middle-aged persons, health professionals need greater understanding of the experience of coping with multimorbidity and the associated healthcare burden.