CaHRU/LIH Improvement Science and Research Methods Seminar: The journey to multimorbidity in an inner city community – Dr Mark Ashworth

The CaHRU/LIH Improvement Science and Research Methods Seminar on 13 November 2019 was given by Dr Mark Ashworth from Kings College London. Dr Ashworth trained at Southampton University and has been a GP for 30 years in an inner city GP training practice with a parallel career in academic primary care. His doctorate was based on quantifying changes in prescribing metrics. He has developed research interests in primary care mental health, multimorbidity (especially the intersection of mental and physical illness) and antibiotic prescribing.

In 1999, Dr Ashworth chaired the research group that developed a patient generated mental health outcome measure called ‘PSYCHLOPS’ (Psychological Outcome Profiles). This was originally intended to focus on patient generated outcomes as opposed to the more generic outcomes measured by standard (standardised) measures. In 2015, PSYCHLOPS was taken up by WHO because of its ‘cultural neutrality’ as part of a WHO mental health programme in conflict zones. It continues to be used in conflict zones across the world.


The seminar, , titled ‘The journey to multimorbidity in an inner city community’, presented novel methods using patient-level primary care data to study multimorbidity in an inner London community. Dr Ashworth illustrated the ‘alluvial plot’, used in Charles Minard‘s Map of Napoleon’s Russian Campaign of 1812, to unravel some of the complexities of multimorbidity including the rate of progression of multimorbidity, the characteristics of rapid progressors, and the role of social deprivation and ethnicity in predisposing to multimorbidity. The plots were used to show the progression from and initial long-term condition to multimorbidity and relative roles of social deprivation and cardiovascular risk factors as the main determinants of multimorbidity.

The next seminar will be on ‘Researching rare diseases’ Wed 11 December at 11am Sarah Swift Building 0203.

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Prof A. N. Siriwardena

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