Remission of long-term conditions among adults with multiple long-term conditions in England primary care: A retrospective cohort study of 4.7 million people
- 1Primary Care Research Centre, University of Southampton, Southampton, SO16 5ST United Kingdom
- 2Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
Abstract
Background: Multiple long-term conditions (MLTC) are increasingly prevalent among UK adults, yet the extent to which remission of long-term conditions is recorded in routine primary care remains poorly understood. Accurate documentation of remission has implications for clinical management, disease trajectories, and the use of electronic health records in research. Examining remission in the context of MLTC is important because remission in one condition may alter overall disease burden and treatment needs in people living with several coexisting conditions. We aimed to describe the frequency and variation of recorded remission across multiple long-term conditions among adults.
Methods: We conducted a retrospective cohort study using linked primary care, hospital, and CPRD Aurum data. Adults aged ≥ 18 with MLTC (≥ 2 long-term conditions) between Jan 1, 1987, and Dec 31, 2020, were included. Remission was defined using condition-specific criteria based on remission or resolution codes, relevant clinical measurements meeting predefined thresholds, treatment patterns, and condition-specific clinical events recorded in electronic health records. We examined remission for 10 conditions with operationalizable definitions. Analyses were descriptive, summarising remission frequencies and sociodemographic patterns.
Results: Among 4,745,099 adults followed for a median of 8 years, 900,609 (19%) had recorded remission of at least one condition. Remission varied substantially by condition, with the highest rates observed for anaemia (63.0%), asthma (44.71%), and diabetes (15.51%), calculated among people with an ever-recorded diagnosis of each condition. Those with remission were slightly younger and more often male; Asian and Black ethnic groups were under-represented, while deprivation patterns were broadly similar.
Conclusions: Recorded remission in MLTC is highly heterogeneous and often rare. Variation between conditions and low rates of sustained remission likely reflect coding practices and clinical recording behaviours. Standardised remission definitions and consistent Systematised Nomenclature of Medicine (SNOMED) coding could improve data quality and support more reliable research on remission and disease trajectories.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12916-026-05106-1.
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BibTeX
@article{jat2026remission,
title = {{Remission of long-term conditions among adults with multiple long-term conditions in England primary care: A retrospective cohort study of 4.7 million people}},
author = {Aman Jat and Benjamin D Barton and Rohini Mathur and Beth Stuart and Hilda Hounkpatin and Hajira Dambha-Miller},
journal = {BMC Medicine},
year = {2026},
month = aug,
doi = {10.1186/s12916-026-05106-1},
url = {https://doi.org/10.1186/s12916-026-05106-1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Remission of long-term conditions among adults with multiple long-term conditions in England primary care: A retrospective cohort study of 4.7 million people
AU - Aman Jat
AU - Benjamin D Barton
AU - Rohini Mathur
AU - Beth Stuart
AU - Hilda Hounkpatin
AU - Hajira Dambha-Miller
PY - 2026
DA - 2026/08/10
JO - BMC Medicine
DO - 10.1186/s12916-026-05106-1
UR - https://doi.org/10.1186/s12916-026-05106-1
AB - Background: Multiple long-term conditions (MLTC) are increasingly prevalent among UK adults, yet the extent to which remission of long-term conditions is recorded in routine primary care remains poorly understood. Accurate documentation of remission has implications for clinical management, disease trajectories, and the use of electronic health records in research. Examining remission in the context of MLTC is important because remission in one condition may alter overall disease burden and treatment needs in people living with several coexisting conditions. We aimed to describe the frequency and variation of recorded remission across multiple long-term conditions among adults. Methods: We conducted a retrospective cohort study using linked primary care, hospital, and CPRD Aurum data. Adults aged ≥ 18 with MLTC (≥ 2 long-term conditions) between Jan 1, 1987, and Dec 31, 2020, were included. Remission was defined using condition-specific criteria based on remission or resolution codes, relevant clinical measurements meeting predefined thresholds, treatment patterns, and condition-specific clinical events recorded in electronic health records. We examined remission for 10 conditions with operationalizable definitions. Analyses were descriptive, summarising remission frequencies and sociodemographic patterns. Results: Among 4,745,099 adults followed for a median of 8 years, 900,609 (19%) had recorded remission of at least one condition. Remission varied substantially by condition, with the highest rates observed for anaemia (63.0%), asthma (44.71%), and diabetes (15.51%), calculated among people with an ever-recorded diagnosis of each condition. Those with remission were slightly younger and more often male; Asian and Black ethnic groups were under-represented, while deprivation patterns were broadly similar. Conclusions: Recorded remission in MLTC is highly heterogeneous and often rare. Variation between conditions and low rates of sustained remission likely reflect coding practices and clinical recording behaviours. Standardised remission definitions and consistent Systematised Nomenclature of Medicine (SNOMED) coding could improve data quality and support more reliable research on remission and disease trajectories. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12916-026-05106-1.
SN - 1741-7015
ER -