Prevention and Management of Multimorbidity in Southeast Asia: A Narrative Review

Multimorbidity, the coexistence of two or more chronic conditions, presents a growing global challenge, particularly in low- and middle-income countries such as Southeast Asia. This trend necessitates the development of sustainable integrated care models to prevent and manage multimorbidity effectively. However, progress in this area has been hampered, especially in underdeveloped regions, by various barriers, including the epidemiology of multimorbidity, how to get different specialists and doctors to work together most availably and manage the multiple medication issues and how to develop cost-effective approaches to reduce the health burden of multimorbidity. Preventive measures in Southeast Asia, which could tackle multiple components which commonly comprise multimorbidity, include enhancing health literacy and health promotion through school- and community-based educational activities, primary healthcare and related policies on employing taxes on tobacco, alcohol and sugary beverages. The social determinants of health-encompassing poverty and low education may also influence research on multimorbidity. Moreover, stakeholder engagements involving national governments, World Health Organization (WHO) and Association of Southeast Asian Nations (ASEAN) are crucial. Management strategies focus on integrated care models, including patient-centred primary healthcare, digital healthcare technologies, and medication management to control polypharmacy. Although research on multimorbidity in Southeast Asia is increasing, translating findings into practical measures was limited. Future efforts should prioritize evidence-based approaches to prevent and manage multimorbidity effectively, addressing challenges like health system focusing on single chronic disease treatment independently, resource limitations, healthcare provider shortages and individual adherence issues. These ways promise to enhance the quality of life and health outcomes in this region.