Overview of IMPACT

THE COSMOS DELPHI SURVEY IS NOW LIVE! Developing a ‘Core Outcome Set’ for multimorbidity trials in LMIC (COSMOS).  If you are a patient, clinician, researcher or policy maker with experience of multimorbidity (living with two or more health conditions),  please click  here.

The ‘IMPACT in South Asia’ programme is funded by the National Institute for Health and Care Research and is a collaboration between partners in Bangladesh, India, Pakistan and the UK. The group includes researchers, clinicians, policy makers and patient and public representatives.

Programme goals
The aim of the programme is to work together will all key stakeholders to tackle the challenge of mental and physical multimorbidity. This affects some of the poorest and most vulnerable people in low and middle income countries. Our goals are to improve health and reduce deaths associated with diabetes, heart and lung diseases in people with severe mental illness (SMI) (i.e. schizophrenia and bipolar disorder). And to reduce depression and anxiety in people with chronic physical health conditions. We are also building research capacity for applied health research on multimorbidity.

Mental and physical multimorbidity
People with SMI die around 20 years earlier than the general population. This is mainly because of preventable chronic physical disorders.  There are many reasons for this.  The higher prevalence of health risk behaviours such as smoking, physical inactivity, poor diet and alcohol contributes. So does the additional challenge of getting good care for physical health problems in the presence of a mental disorder. And the treatments for mental illnesses may also increase the risk of obesity and diabetes.

Around 30% of those with a chronic physical disorder also have depression or anxiety. These conditions often go undetected and untreated. And they are known to worsen outcomes for physical illness.

The coexistence of mental and physical illness is a major and growing problem, particularly in South Asia, and it affects some of the poorest and most vulnerable people.

The team
With our collective multidisciplinary research and clinical expertise, and the knowledge and understanding our partners bring about health systems and social, political and cultural contexts in Bangladesh, India and Pakistan, the IMPACT programme, is in an excellent position to tackle these challenges. You can find out more about the team here.

The IMPACT programme includes several feasibility studies, preparing the way for large-scale research programmes; visit our Research Studies page for further information on these.

Preliminary work carried by the IMPACT Group has been key to securing other funding. The NIHR RIGHT DiaDeM programme and the TB Multimorbidity project both address mental and physical multimorbidity and are built on findings and collaborations from IMPACT.

Patient, community and public involvement
To ensure our programme keeps a clear focus on the needs of people with mental and physical multimorbidity, we have put patient, community and public engagement at the heart of all our research.

Each study has a Community Advisory Panel (CAP).  The panel includes patients, carers and supporters, and community representatives. The role of the CAP is to advise us on the design of our studies and interventions.

Capacity building
Another priority for the IMPACT in South Asia programme is capacity development. Our focus is on developing research methods, research management and research leadership skills.

We aim to build world-class research teams in low and middle income countries. This will provide a platform for securing large-scale grants to address the critical lack of evidence on effective interventions for mental and physical multimorbidity.



This research was funded by the National Institute for Health and Care Research (NIHR) (17/63/130) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK government.