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Multi-morbidity has been described as the most common chronic condition in adults. The rise of multi-morbidity, its burden on population health (e.g. increased mortality and lower quality of life), healthcare budget (e.g. high use of healthcare services) and society (e.g. reduced productivity) requires deeper understanding of multi-morbidity to effectively design and deliver health services. COVID-19 may have placed increased burden on multi-morbid patients to self-manage as health services have needed to be directed towards managing the pandemic. Potentially, health outcomes, such as quality of life, may have been impacted less in people who are more able to self-manage. Although patient self-management is essential in managing chronic conditions, the effectiveness and cost-effectiveness of self-management for people with multi-morbidity is largely unknown. 


A mixed-methods observational study will investigate a) the level of self-management in a multi-morbid population and its association with quality of life outcomes, b) experiences with self-management including support given from health and social care services, c) the association between self-management and health and social care costs. This will be done by

-          conducting a systematic review on outcomes, experiences of self-management support, and costs of self-management in people with multi-morbidity,

-          interviewing professional stakeholders and people with multi-morbidity about self-management support provided by health and social services, strategies and skills employed, and associated costs to deliver self-management interventions for people with multi-morbidity,

-          conducting an electronic survey with patients to investigate their level of self-management, received informal care, quality of life, and use of health and social care services.

There will be opportunities to learn about mixed methods research, applied health services research and health economics. Patient-reported outcome measurement (PROMs) and their use in research will be a strong feature of this project. There will be opportunities to attend training courses for example on online data collection, qualitative methods, health economics and statistics. Patient and public involvement (PPI) will feature strongly to ensure the project addresses issues of importance to patients.


The project will be conducted within the Health Services Research Unit (HSRU) in close collaboration with the Health Economics Research Centre (HERC). Both HSRU and HERC are units within NDPH.

prospective candidate

The successful candidate should ideally have experience of conducting qualitative (e.g. interviews) and quantitative (e.g. analysis of survey data) research in patients with chronic disease. The project would suit someone with a clinical or non-clinical background who is knowledgeable in medical sociology/health psychology and health services research. Knowledge of patient-reported outcome measurement, health care policy and health economics would be an advantage.