Recommendations for conducting qualitative research on multiple long-term conditions (MLTC) from a qualitative methods community of practice

The growing prevalence of multiple long-term conditions (MLTC) - two or more long-term health conditions - has been recognised as one of the most significant health challenges facing contemporary societies. People living with MLTC experience poorer outcomes than people with one long-term condition and may be disadvantaged by health care systems configured for single conditions. Recognition of the significance of these inequities has led to increased investments in MLTC research, and a body of qualitative literature on lived experience is developing. However, conducting qualitative MLTC research presents challenges to researchers. Encompassing an extensive range of condition combinations, the MLTC population is incredibly diverse, and constructing a sampling strategy for the small numbers of participants typical in qualitative inquiry requires careful thought. Additionally, MLTC is a construct not embedded in public consciousness, which may affect participant self-identification and research engagement. Furthermore, the risk of issues commonly experienced in qualitative health research, such as participant distress and low recruitment rates, can be exacerbated due to the ill-health experienced by some people living with MLTC. In this article, we share reflections from a cross-institution Qualitative Methods Community of Practice in MLTC Research, describing the challenges experienced and practical steps taken to address difficulties and mitigate risks. We aim to provide tips and guidance to qualitative health researchers new to MLTC inquiry to support planning and delivery of their research in this rapidly growing field.