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Multimorbidity-usually defined as the co-existence of two or more long-term conditions in an individual-is the norm rather than the exception in primary care patients 1, 2 and will become more prevalent as populations age. 3, 1 Multimorbidity cuts across the vertical paradigms in which most health research and policy is envisaged, supported and carried out, reflecting not only specialist interests in particular problems and diseases, but also the tendency of research to focus on easily defined issues.‘‘Complicated’’patients with multimorbidity are usually excluded from such research. Although complexity is under-represented in the research literature, it is common place in general medical practice, where the challenges are ‘‘horizontal’’, integrating not only at the level of the clinical encounter, but also in the co-ordination of services to support patients with multiple problems. The challenge of carrying out research on …