A primary care research agenda for multiple long-term conditions: a Delphi study

Background
Multiple long-term conditions (MLTC, multimorbidity) has been identified as a priority research topic, globally. Research priorities from the perspectives of patients and research funders have been described. Although most care for MLTC is delivered in primary care, the priorities of academic primary care have not been identified.
Aim
To identify and prioritise the academic primary care research agenda for MLTC.
Design and Setting
Three-phase study with primary care MLTC researchers from the UK and other high-income countries.
Method
(i) Open-ended survey question; (ii) face-to-face workshop to elaborate questions with researchers from the UK and Ireland; (iii) and a two-round Delphi consensus survey with international multimorbidity researchers.
Results
Twenty-five primary care researchers responded to the initial open-ended survey and generated 84 potential research questions. In the subsequent workshop discussion (18 participants), this list was reduced to 31 questions. The long list of 31 research questions was included in round one of the Delphi; 27 of the 50 (54%) round one and 24 of the 27 to round two (89%) invitees took part in the Delphi. Ten questions reached final consensus. These focused broadly on addressing complexity of the patient group with (a) development of new models of care for multimorbidity, (b) methods and data development.
Conclusion
These high priority research questions offer funders and researchers a basis upon which to build future grant calls and research plans. Addressing complexity in our research is needed to inform improvements in our systems of care and for prevention.