Patterns of psychopathology and personal strengths among youth in psychiatric care.

Cardiovascular disease (CVD) is a dominant burden of ill health with approximately 523 million cases and 17.3 million deaths documented globally in 2019 projected to rise to 35.6 million deaths by 2050. Heart failure (HF) is one of the most prevalent forms of CVD affecting 64 million people worldwide, whilst the overall global prevalence of multimorbidity is calculated at 37.2%. The complexity of HF management is increasing due to its coexistence with two or more chronic health conditions, widely referred to as multimorbidity, shifting from the exception to the norm. A common occurrence in multimorbid HF is cardio renal metabolic (CaReMe) syndrome, a collection of interactive cardiovascular, renal, and metabolic co-morbidities, which impact disease severity, response to treatment and HF outcomes. HF frequently occurs with this cluster of conditions and may represent both a consequence and a driver of CaReMe disease processes. Therefore, this review considers HF and CaReMe syndrome as overlapping clinical entities rather than separate conditions. The predisposition to multimorbidity in HF is mirrored by its rising incidence and mortality rates, with epidemiology indicating adverse individual, societal and economic impact. Models of care outline how services are organised and delivered, clarifying care processes, provider roles, and coordination. Understanding functioning models for individuals with multimorbid HF and CaReMe syndrome is essential to guide change from disease focus systems to person-centred integrated approaches, when combined with health professional support and patient behaviour modifications. These models may enhance care delivery, reduce health disparities, optimise treatments and promote equitable, reproducible care. Integrated patient care is defined as the continuous delivery of coordinated services that bring together support systems to meet patient needs, optimise wellbeing, and promote shared decision-making (SDM) between patients and healthcare providers. In the UK, place-based partnerships encourage collaborative, patient-centred care. In the US, rising chronic disease prevalence, healthcare costs, and fragmented care have driven policies that incentivise integration of health and social care. Globally, the WHO framework supports a life-course approach, shifting from siloed healthcare to integrated, disease-based service delivery tailored to individual values and contexts. Evidence indicates that coordinated models of integrated care can improve care for patients and caregivers, enhancing quality of life and reducing care burden. These and are promoted by advisory groups and international guidelines emphasising SDM.