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糖尿病及合并症患者诊断与治疗中的多学科团队:一项范围综述。

The multidisciplinary team in diagnosing and treatment of patients with diabetes and comorbidities: A scoping review.

作者信息

Andersen Jonas Dahl, Jensen Morten Hasselstrøm, Vestergaard Peter, Jensen Vigga, Hejlesen Ole, Hangaard Stine

机构信息

Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.

Steno Diabetes Center North Denmark, Aalborg, Denmark.

出版信息

J Multimorb Comorb. 2023 Mar 20;13:26335565231165966. doi: 10.1177/26335565231165966. eCollection 2023 Jan-Dec.

Abstract

BACKGROUND

Multidisciplinary Teams (MDTs) has been suggested as an intervention to overcome some of the complexities experienced by people with diabetes and comorbidities in terms of diagnosis and treatment. However, evidence concerning MDTs within the diabetes field remains sparse.

OBJECTIVE

This review aims to identify and map available evidence on key characteristics of MDTs in the context of diagnosis and treatment in people with diabetes and comorbidities.

METHODS

This review followed the PRISMA-ScR guidelines. Databases PubMed, EMBASE, and CINAHL were systematically searched for studies assessing any type of MDT within the context of diagnosis and treatment in adult people (≥ 18 years) with diabetes and comorbidities/complications. Data extraction included details on study characteristics, MDT interventions, digital health solutions, and key findings.

RESULTS

Overall, 19 studies were included. Generally, the MDTs were characterized by high heterogeneity. Four overall components characterized the MDTs: Both medical specialists and healthcare professionals (HCPs) of different team sizes were represented; interventions spanned elements of medication, assessment, nutrition, education, self-monitoring, and treatment adjustment; digital health solutions were integrated in 58% of the studies; MDTs were carried out in both primary and secondary healthcare settings with varying frequencies. Generally, the effectiveness of the MDTs was positive across different outcomes.

CONCLUSIONS

MDTs are characterized by high diversity in their outline yet seem to be effective and cost-effective in the context of diagnosis and treatment of people with diabetes and comorbidities. Future research should investigate the cross-sectorial collaboration to reduce care fragmentation and enhance care coordination.

摘要

背景

多学科团队(MDTs)已被提议作为一种干预措施,以克服糖尿病合并症患者在诊断和治疗方面所经历的一些复杂性。然而,糖尿病领域内关于多学科团队的证据仍然很少。

目的

本综述旨在识别和梳理关于多学科团队在糖尿病合并症患者诊断和治疗背景下关键特征的现有证据。

方法

本综述遵循PRISMA-ScR指南。系统检索了PubMed、EMBASE和CINAHL数据库,以查找评估在患有糖尿病和合并症/并发症的成年人(≥18岁)诊断和治疗背景下任何类型多学科团队的研究。数据提取包括研究特征、多学科团队干预措施、数字健康解决方案和主要研究结果的详细信息。

结果

总体而言,纳入了19项研究。一般来说,多学科团队的特点是高度异质性。多学科团队有四个总体组成部分:不同团队规模的医学专家和医疗保健专业人员(HCPs)都有代表;干预措施涵盖药物治疗、评估、营养、教育、自我监测和治疗调整等方面;58%的研究中整合了数字健康解决方案;多学科团队在初级和二级医疗保健环境中以不同频率开展。一般来说,多学科团队在不同结局方面的有效性是积极的。

结论

多学科团队在其概况上具有高度多样性,但在糖尿病合并症患者的诊断和治疗背景下似乎是有效且具有成本效益的。未来的研究应调查跨部门合作,以减少护理碎片化并加强护理协调。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c8/10031602/b25755555e7f/10.1177_26335565231165966-fig1.jpg

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