A New Approach to a Complex Challenge

More than half of all individuals with a chronic illness are affected by at least one additional chronic condition—a phenomenon known as multimorbidity. This represents one of the most pressing healthcare challenges of our time. Yet, healthcare systems are often structured to treat one disease at a time, rather than addressing the needs of the whole person.

Qualitative studies have shown that this fragmented approach is unsatisfactory for both patients and healthcare professionals. There is a clear lack of research into effective, patient-centered treatment strategies for people with multimorbidity.

The MOBILIZE project aims to change that. Over the past five years, we have systematically reviewed the existing evidence, co-developed the MOBILIZE program in close collaboration with patients, caregivers, and clinicians, tested the program in a feasibility study, and finally evaluated its effectiveness in a randomized controlled trial involving 228 participants. All participants were living with at least two of the following conditions: knee or hip osteoarthritis, chronic obstructive pulmonary disease (COPD), heart disease (heart failure or ischemic heart disease), hypertension, type 2 diabetes, or depression. On average, participants had seven chronic conditions, and many were living with additional diseases not specified in this list.

The primary outcome was quality of life, but the study also assessed a wide range of secondary outcomes, including physical function, depressive symptoms, and overall disease burden.

Learn more about each phase of the project under Our Research.

What Does the Program Involve?

The MOBILIZE program is a 12-week intervention designed to empower individuals with multimorbidity through personalized exercise therapy and self-management sessions. It consists of three core components:

• Individual Assessment and Goal Setting
  Each participant begins with a one-on-one session with a therapist to clarify personal goals and determine an appropriate starting level for physical activity. This ensures that the program is tailored to the individual’s needs and capabilities.
• Twice-Weekly Group Exercise Sessions
  Participants engage in supervised group exercise twice a week. Each session includes a personalized exercise plan focusing on balance and strength training, along with a flexible component where participants can choose from various exercise modalities based on their preferences and goals.
• Brief Self-Management Modules
  Before each exercise session, participants attend short self-management sessions covering topics such as sleep, pain management, and physical activity. These modules are designed to equip participants with practical tools to better manage life with multiple chronic conditions.

Aiming for Long-Term Impact

The overarching goal of the MOBILIZE program is to enhance participants’ ability to actively engage in their own care. By doing so, the program seeks to reduce symptoms associated with individual conditions, improve quality of life and physical function, and help prevent the onset of additional health problems.

What Do the Results Show?

In the randomized controlled trial, participants were randomly assigned to either receive the new 12-week MOBILIZE program alongside their usual care or to continue with usual care alone. After 12 months, the findings were clear: participants who took part in the MOBILIZE program experienced a statistically significant improvement in their quality of life.

Importantly, the study also demonstrated that engaging in exercise therapy is both safe and feasible—even for individuals living with multiple chronic conditions.

These results have been published in the prestigious journal Nature Medicine, marking a significant step forward in the treatment and management of multimorbidity.

Why Does It Matter?

Multimorbidity is associated with reduced physical function, lower quality of life, increased risk of depression, and greater reliance on medication and healthcare services. Despite its growing prevalence, there is still a lack of research on how best to support this complex and diverse patient population.

MOBILIZE is one of the first projects to systematically investigate the effects of a combined exercise therapy and self-management intervention across multiple chronic conditions. It represents an important step toward a more integrated, patient-centered approach to care—one that focuses on the whole individual, not just their diagnoses.

The MOBILIZE project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant agreement No 801790).