Department of Cardiology, Manchester University NHS Foundation Trust, Manchester, UK; Division of Cardiovascular Sciences, University of Manchester, Manchester, UK.
Department of General & Invasive Cardiology, Barts Heart Centre, St Bartholomew's Hospital Trust, London, UK.
Clin Med (Lond). 2024 Nov;24(6):100243. doi: 10.1016/j.clinme.2024.100243. Epub 2024 Sep 12.
Multidisciplinary meetings (MDMs) are central to clinical decision-making in many areas of cardiology. This study assessed current provision and structure of cardiology MDMs in England in comparison with national guidelines. British Cardiovascular Society (BCS) members were surveyed regarding frequency, core attendees, and organisational aspects of cardiology MDMs for myocardial revascularisation, endocarditis, heart failure, aortic valve, mitral and tricuspid valve MDMs, whether local, regional or outside of the region. Access to electrophysiology (EP), inherited cardiac conditions, and adult congenital heart disease (ACHD) MDMs was also assessed. Survey responses were received from 64 hospitals across England, of which 40 (62%) were secondary care centres and 24 (38%) were tertiary care centres. All units had access to revascularisation MDMs, although 6% of them (all in secondary care centres) lacked any surgical representation. Heart failure MDMs were available in 94% of centres, but 7% reported no attendance by a cardiologist with specialist interest in heart failure, and 23% reported no attendance by a device specialist. 61% of centres had access to dedicated endocarditis MDMs; however, 11% were not attended by a microbiologist or infectious disease physician, and 22% were not attended by a surgeon. Aortic valve MDMs were available in 69% of centres, while mitral and tricuspid valve MDMs were available in 56% of centres. One quarter of centres reported no access to EP, and one third of centres reported no access to ICC or ACHD MDMs. Substantial improvements in provision and structure of cardiology MDMs in England are needed in order to meet national guidance.
多学科会议(MDM)在许多心脏病学领域的临床决策中至关重要。本研究评估了英格兰心脏病学 MDM 的当前提供情况和结构,以与国家指南进行比较。英国心血管学会(BCS)成员接受了有关心肌血运重建、心内膜炎、心力衰竭、主动脉瓣、二尖瓣和三尖瓣 MDM 的频率、核心参与者和组织方面的调查,以及这些 MDM 是在本地、地区还是地区外进行的。还评估了电生理学(EP)、遗传性心脏病和成人先天性心脏病(ACHD)MDM 的获取情况。调查收到了来自英格兰 64 家医院的回复,其中 40 家(62%)为二级保健中心,24 家(38%)为三级保健中心。所有单位都可以获得血运重建 MDM,但其中 6%(均为二级保健中心)缺乏任何手术代表。心力衰竭 MDM 可在 94%的中心获得,但 7%的中心报告没有专门研究心力衰竭的心脏病专家参加,23%的中心报告没有设备专家参加。61%的中心可以获得专门的心内膜炎 MDM,但 11%的中心没有微生物学家或传染病医生参加,22%的中心没有外科医生参加。主动脉瓣 MDM 可在 69%的中心获得,而二尖瓣和三尖瓣 MDM 可在 56%的中心获得。四分之一的中心报告无法获得 EP,三分之一的中心报告无法获得 ICC 或 ACHD MDM。为了符合国家指南,英格兰需要在心脏病学 MDM 的提供和结构方面进行重大改进。