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Multiple long term conditions (MLTC or multimorbidity) refer to the presence of two or more long term conditions.1 Such combinations of conditions are experienced by approximately one third of the population globally2 3; and exhibit a clear social gradient, with individuals in lower socioeconomic groups experiencing higher prevalence and onset at an earlier age.3 4 People with MLTC experience fragmented care, high treatment burden, and avoidable hospital use, which come with personal, social, and economic impacts.5 Clinical guidelines provide evidence based recommendations to support clinical decision making; however, they remain largely focused on single diseases. A single disease focus poses difficulties for MLTC management, especially where recommendations conflict, compete, or are not readily reconciled across a patient's coexisting conditions.