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一项关于在初级保健中使用多学科团队会议管理多种疾病的干预措施的系统评价。

A Systematic Review of Interventions that Use Multidisciplinary Team Meetings to Manage Multimorbidity in Primary Care.

作者信息

Lammila-Escalera Elena, Greenfield Geva, Barber Susan, Nicholls Dasha, Majeed Azeem, Hayhoe Benedict W J

机构信息

Imperial College London, UK.

Chelsea & Westminster Hospital NHS Foundation Trust, UK.

出版信息

Int J Integr Care. 2022 Oct 18;22(4):6. doi: 10.5334/ijic.6473. eCollection 2022 Oct-Dec.

Abstract

INTRODUCTION

Multidisciplinary team (MDT) meetings could facilitate coordination of care for individuals living with multimorbidity, yet there is limited evidence on their effectiveness. We hence explored the common characteristics of MDT meetings in primary care and assessed the effectiveness of interventions that include such meetings, designed to improve outcomes for adults living with multimorbidity.

METHODS

A systematic review of literature was conducted using MEDLINE and EMBASE. A narrative synthesis was performed, extracting study and MDT meeting characteristics, in addition to any outcomes reported.

RESULTS

Four randomised controlled trials that were conducted in the United States of America were identified as eligible, recruiting a total of 3,509 adults living with multimorbidity. Common MDT meeting themes include regular frequency of discussion, the absence of patient involvement and the participation of three or four multiprofessionals. Significant improvements were observed in response to interventions with an MDT component across most measures, yet this trend did not extend to physical health outcomes.

DISCUSSION

It is unclear if the results in this review are sufficient to support the widespread implementation of MDT meetings in primary care, for adults living with multimorbidity. Due to the paucity of studies collated, further research is required to inform widespread implementation.

摘要

引言

多学科团队(MDT)会议有助于协调患有多种疾病的个体的护理工作,但关于其有效性的证据有限。因此,我们探讨了初级保健中MDT会议的共同特征,并评估了包括此类会议在内的干预措施的有效性,这些干预措施旨在改善患有多种疾病的成年人的治疗效果。

方法

使用MEDLINE和EMBASE对文献进行系统综述。进行了叙述性综合分析,除了报告的任何结果外,还提取了研究和MDT会议的特征。

结果

确定在美国进行的四项随机对照试验符合条件,共招募了3509名患有多种疾病的成年人。MDT会议的常见主题包括定期讨论频率、患者未参与以及三或四名多专业人员的参与。在大多数指标上,对包含MDT组成部分的干预措施的反应有显著改善,但这一趋势并未延伸至身体健康结果。

讨论

尚不清楚本综述中的结果是否足以支持在初级保健中为患有多种疾病的成年人广泛实施MDT会议。由于整理的研究较少,需要进一步研究以为广泛实施提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb2/9585979/054ce738464a/ijic-22-4-6473-g1.jpg

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