A comparison of policies and guidelines related to multimorbidity in the UK, Australia and Sri Lanka

DISCUSSION: Increased rates of multimorbidity, evident in developed and developing countries, should be addressed by health policy. The aim of this study was to compare policies and guidelines related to multimorbidity in primary healthcare in countries with different health systems, to identify initiatives, gaps and opportunities for further improvement. We conducted a content analysis of UK, Australian and Sri Lankan policy documents and guidelines published between 2006 and 2017, in electronic databases, references and government repositories, tabulating data extracted for content, implementation plans, gaps and opportunities for development. Overall, 38 of the 56 identified documents explicitly or implicitly addressed multimorbidity or its prevention. The UK had four policy documents and guidelines specifically on multimorbidity. Australia and Sri Lanka lacked specific policies on multimorbidity, but policies did address chronic conditions and non-communicable diseases. Important differences exist in how national policies seek to address multimorbidity. Policy implementation, how this affects quality of care and outcomes, and the role of primary care should be examined.