MOBILIZE · Improving health in people with multimorbidity: a paradigm shift in health care from disease-based curative models to personalized exercise therapy and self-management

The goal of this proposal is to support the paradigm shift in the health care of people with multiple chronic conditions in Europe from a focus on disease-based curative models to holistic person-centered self-care through personalized,supervised exercise therapy and education.The problem:The impact of multimorbidity on the individual and society is massive and much greater than the impact of single chronic conditions alone. However, effective treatments are missing and research and health care reinforce an inefficient and burdensome single-disease framework.The solution:Exercise has the potential to disrupt the ‘vicious cycle’ of systemic inflammation associated with chronic conditions and improve health in multimorbidity. A personalized exercise and education program aimed at supporting subsequent self-management by the individual will be developed in an interdisciplinary collaboration, building on evidence from biomarkers, patient involvement and methodological expertise. Self-reported,physiological and societal effects will be investigated in a randomized controlled trial comparing the personalized program with standard single-disease models of care. Scientific and public dissemination and implementation ensuring significant personal and societal benefit is fundamental to the proposal.The proposal is associated with high risk, as the current disease-based curative models involve treatment by several highly specialized health care providers, while the new person-centered self-management model is centered on a personalized program delivered by one health care provider.The ground-breaking nature of this proposal lies in its potential to revolutionize how health care is organized for people with multimorbidity, by giving them one primary care provider, and how we use non-surgical treatment in health care and science by bringing the concept of precision medicine into multimorbidity and utilizing it to improve treatment outcome with exercise therapy as the model.