Multidisciplinary team meetings appear to be effective in inflammatory bowel disease management: an audit of process and outcomes.

BACKGROUND

Multidisciplinary team meetings (MDTM) have proven efficacy in cancer management. Whilst widely implemented in inflammatory bowel disease (IBD) care, their value is yet to be investigated. We reviewed the performance of MDTM for IBD patients.

METHODS

Retrospective review of MDTM from March 2013 to July 2016. Each patient's first MDTM was considered. Data collected included: report production and location, disease factors, recommendation(s), implementation and barriers to implementation. The MDTM process was considered successful when at least top-level recommendations were implemented within 6 months.

RESULTS

MDTM attendance included an IBD gastroenterologist, surgeons, a radiologist, nurses, dieticians, psychologists and clinical trial staff. Initial MDTM encounters of 166 patients were reviewed: 86 females, mean age 40 years, 140 (84.3%) with Crohn disease and mean disease duration of 10.8 years (interquartile range 15 years). Electronic reports were filed for all patients, with hard copies in 84%. In 151 of 166 episodes, all (n = 127) or top-line (n = 24) recommendations were implemented, although there was a delay beyond 6 months in 5. Of 146 patients with a successful MDTM, 85 (58.2%) were in clinical remission at last review (median follow up: 27 months). Amongst patients with unsuccessful MDTM (n = 13), only two (15.4%) were in clinical remission at follow up. Barriers to implementation included patients declining recommendations and loss to follow up.

CONCLUSION

The majority of MDTM encounters were successful from both a process and clinical outcome perspective. System opportunities to improve the process include ensuring that 100% of reports are available and addressing implementation delays. Patient factors that require addressing include improved engagement and understanding reasons for declining recommendations.