OPTIMAL research project

OPTIMising therapies, disease trajectories, and AI assisted clinical management for patients Living with complex multimorbidity


Logo for OPTIMAL project: Improving the lives of people living with multiple long-term conditions

Cartoon image of a group of people holding various medications


Doctors currently treat different diseases separately. They prescribe a different drug for each condition, which may not help people who have four or more complex multiple long-term conditions.

A medical treatment for one disease can make another disease worse or better, but there’s very little information on this. This means we are not sure which medical treatments will have the best outcomes for patients with multiple long-term conditions.

We can group such people based on their mixes of disease and study the effects of a medical treatment on each disease mix. 

This should help doctors prescribe medical treatments more efficiently, and that would benefit almost all people living with multiple long-term conditions.


  • Find the mix of diseases and medical treatments that interact over time to worsen or improve a patient’s health
  • Predict the next disease that people might develop
  • Find medical treatments that help more than one disease
  • With input from patient representatives and health professionals, produce computer programs to help doctors improve the choice of medical treatments in people with multiple long-term conditions

How will we do this?

  1. Link large, detailed health records from a selection of patients who have attended GP services and hospitals since 2000.
  2. Using artificial intelligence (AI) methods, model how the different mixes of diseases in these patients arise over time. The models will tell us which medical treatments cause /prevent a new disease, and predict who may be at risk of developing another disease soon.
  3. Ask patient representatives and doctors about their views on using AI to guide clinical decisions. This will help us make the AI models better to use in practice.
  4. Use AI computer techniques to combine data, and together with the input from patient representatives and doctors, develop a computer program. This will predict which medical treatment we should give and when, as well as what disease people may get next.
  5. Examine the best way to present information in the computer program to patients, the public and doctors by finding out what is important to them and what options they prefer.

Our team

Our team includes patients, public members, and world leading experts from three universities with expertise in biology, AI, medicine, health service research, public health, and general practice.

Team members

University of Birmingham / University Hospitals Birmingham

University of Oxford:

Univesity of St Andrews:

NHS Greater Glasgow & Clyde:


Patient Advisory Group:

Our patient advisory group (PAG) consists of our 2 public co-applicants, plus 6 people with a range of diverse lived experiences of multiple long-term conditions, either managing their own conditions or supporting someone they are close to. Our PAG influences how the research is carried out across all work packages.

Frequently asked questions

Why is this research important?

As the ageing population increases, larger numbers of older people will experience multiple long-term conditions which require medical treatment. 

A better understanding of how to manage these conditions with the best combination of medical treatments will help older people to manage their symptoms more effectively and improve their quality of life.

How will this work impact on patients in the future?

We hope that this work will mean that patients with multiple long-term conditions in the future receive the best possible combination of medical treatments.

How have you involved patients and members of the public in the design of this programme?

Two Patient/Public partners have been involved with the development of the OPTIMAL programme from the application stage. Both partners attend regular management, executive and data meetings, as well as a Patient Advisory Group.

Who is funding the research?

This project is funded by the National Institute for Health & Care Research (NIHR) under its Programme Artificial Intelligence for Multiple and Long-Term Conditions (NIHR202632). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

The OPTIMAL programme has received just under £2.5m in funding from the NIHR and will run until April 2025.

NEW NIHR logo (national institute for health and care research)


UKRI | UK Research and Innovation


Contact us

Public Involvement & Engagement enquiries: Leah Fitzsimmons (l.fitzsimmons@bham.ac.uk

Any other enquiries – optimal@contacts.bham.ac.uk 

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