Long Term Conditions
Long Term Conditions Theme
The Long Term Conditions (LTC) Theme, led by Professor Mari Carmen Portillo with Deputy Lead Dr Dorit Kunkel, delivers a broad programme of research and implementation designed to improve the lives of people living with long‑term conditions and multiple long‑term conditions. The theme’s work spans deprescribing, medicines optimisation, treatment burden, physical activity, service improvement, co‑production, and person‑centred care.
A major area of impact is medication deprescribing and optimisation. The MODIFY project has significantly enhanced safety and quality of life for frail older adults by adopting a structured, multidisciplinary approach to medication reviews. It supports clinicians through training, tools, and collaborative working models, and is now embedded within wider system initiatives such as the Wessex Health Innovation Network’s Polypharmacy Action Learning Sets. Public engagement activities—including creative outputs like a deprescribing song—have helped raise awareness and encouraged culture change in medicines optimisation.
Further medicines‑related research has identified ongoing risks related to inappropriate prescribing of anti-inflammatory painkillers for older adults and those with conditions such as kidney or heart disease. A GP‑focused risk‑identification tool was developed to address this. Another study highlighted that many people on disease‑modifying drugs undergo high‑frequency monitoring despite long‑term normal results, suggesting opportunities to reduce unnecessary burden and NHS workload.
The Treatment Burden Study, involving more than 800 Dorset adults, showed that high burden is common and often driven by lifestyle challenges, appointment access, financial pressure, and complex medication regimens. Its follow‑on project, SPELL, produced short, practical measures for clinical use. The findings also informed improvements for Care Coordinators in Southampton, enabling them to better identify and support individuals struggling with their conditions while reducing demand on GP time.
The theme has also optimised community‑based support systems, developing a Link Worker framework for social prescribing and piloting the LifeBoost app to guide people with LTCs to personalised resources.
The European Optim Park project expanded access to Parkinson’s support via the REPISALUD directory, now used internationally.
Policy influence is another key outcome. Research on COVID‑19, physical activity, and mental health has shaped recommendations adopted by bodies including Sweden's Health Technology Assessment Agency and the European Commission. Findings from Optim Park have informed NICE guideline NG252.
Additional impacts include shaping national and international understanding of Huntington’s disease care needs, advancing person‑centred assessment tools such as the Living with Long Term Conditions Scale, and contributing to workforce development through the Wessex Academy of Skills in Personalised Care, which has trained more than 1,500 professionals.
Finally, work on physical activity maintenance has expanded understanding of the barriers and enablers affecting digital health engagement among NHS staff, strengthening regional partnerships.
Research projects
Mental health hub projects
Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study
Role of patient-assessed functioning as a predictor of health service use in patients with long term mental health conditions
Collaborative project:
Improving review appointments for people with long-term conditions