Lewis Cliona, Wallace Emma, Kyne Lorraine, Cullen Walter, Smith Susan M
Department of General Practice, Royal College of Surgeons in Ireland Medical School, Dublin, Ireland.
School of Medicine, University College Dublin, Dublin, Ireland.
J Comorb. 2016 Aug 26;6(2):85-94. doi: 10.15256/joc.2016.6.87. eCollection 2016.
Patients with multimorbidity (two or more chronic conditions) are now the norm in clinical practice, and place an increasing burden on the healthcare system. Management of these patients is challenging, and requires doctors who are skilled in the complexity of multiple chronic diseases.
To perform a systematic review of the literature to ascertain whether there are education and training formats which have been used to train postgraduate medical doctors in the management of patients with multimorbidity in primary and/or secondary care, and which have been shown to improve knowledge, skills, attitudes, and/or patient outcomes.
Overall, 75,110 citations were screened, of which 65 full-text articles were then independently assessed for eligibility by two reviewers, and two studies met the inclusion criteria for the review.
The two included studies implemented and evaluated multimorbidity workshops, and highlight the need for further research addressing the learning needs of doctors tasked with managing patients with multimorbidity in their daily practice.
While much has been published about the challenges presented to medical staff by patients with multimorbidity, published research regarding education of doctors to manage these problems is lacking. Further research is required to determine whether there is a need for, or benefit from, specific training for doctors to manage patients with multimorbidity. PROSPERO registration number: CRD42013004010.
患有多种疾病(两种或更多慢性疾病)的患者如今在临床实践中很常见,给医疗系统带来了日益沉重的负担。对这些患者的管理具有挑战性,需要医生具备处理多种慢性疾病复杂性的技能。
对文献进行系统综述,以确定是否存在用于培训研究生医生在初级和/或二级护理中管理患有多种疾病患者的教育和培训形式,并且这些形式已被证明能改善知识、技能、态度和/或患者治疗效果。
总共筛选了75110条引文,其中65篇全文文章随后由两位评审员独立评估其是否符合纳入标准,两项研究符合该综述的纳入标准。
纳入的两项研究实施并评估了多种疾病研讨会,并强调需要进一步研究以满足在日常实践中负责管理患有多种疾病患者的医生的学习需求。
虽然关于患有多种疾病的患者给医务人员带来的挑战已有很多报道,但关于医生管理这些问题的教育方面的已发表研究却很缺乏。需要进一步研究以确定是否需要针对医生管理患有多种疾病患者进行特定培训,以及这种培训是否有益。PROSPERO注册号:CRD42013004010。