Shi Yanli, Li Hongmin, Yuan Beibei, Wang Xin
School of Public Health, Sun Yat-Sen University, No.74, the 2nd Zhongshan Road, Guangzhou, Guangdong Province, 510080, China.
School of Public Health, Jining Medical University, Jining, China.
BMC Prim Care. 2025 Apr 15;26(1):110. doi: 10.1186/s12875-025-02814-0.
There is evidence that multidisciplinary teams can improve health outcomes for patients with chronic conditions, enhance the quality and coordination of care, and promote teamwork among staff in hospital settings. However, their effectiveness in non-hospital settings remains unclear. Therefore, we conducted a systematic review and meta-analysis to assess the effects of multidisciplinary teams on patients with chronic conditions, health professionals, and healthcare in non-hospital settings.
We searched PubMed, Web of Science, Embase, EconLit, OpenGrey, China National Knowledge Infrastructure (CNKI), and WanFang for randomised controlled trials published before March 2025. Narrative syntheses were used to synthesise the characteristics of multidisciplinary teams, interventions, and effects. Data were statistically pooled using both random-effects and fixed-effects meta-analyses to synthesize the outcomes. The methodological quality of the included studies was assessed using Cochrane's risk of bias tool.
Thirty-nine studies were analyzed, with a total of 8186 participants. Nurses, general practitioners, and specialists were the most common members of the multidisciplinary teams. Staffing models, shared care and role expansion or task shifting are the most common multidisciplinary teamwork interventions. Narrative syntheses revealed improvements in self-management, self-efficiency, satisfaction, health behaviours, and knowledge. A meta-analysis found a significant reduction in hospitalisation days for patients with chronic obstructive pulmonary disease (MD=-0.66, 95% CI -1.05 to -0.26, I = 0%) and significant improvement in quality of life for patients with chronic heart failure (MD=-4.63, 95% CI: -8.67 to -0.60, I = 0%). There is no consistent evidence of other indicators of this effect.
Multidisciplinary teamwork can improve patient-reported outcomes for patients with chronic conditions in non-hospital settings, but the effects on clinical outcomes, health utilisation, and costs are not evident.
The study protocol was registered with PROSPERO on January 21, 2019, with the registration number CRD42019121109.
有证据表明，多学科团队可以改善慢性病患者的健康状况，提高护理质量和协调性，并促进医院环境中工作人员之间的团队合作。然而，它们在非医院环境中的有效性仍不明确。因此，我们进行了一项系统评价和荟萃分析，以评估多学科团队对非医院环境中慢性病患者、卫生专业人员和医疗保健的影响。
我们检索了PubMed、科学网、Embase、EconLit、OpenGrey、中国知网（CNKI）和万方数据库，查找2025年3月之前发表的随机对照试验。采用叙述性综合分析来综合多学科团队的特征、干预措施和效果。使用随机效应和固定效应荟萃分析对数据进行统计合并，以综合结果。使用Cochrane偏倚风险工具评估纳入研究的方法学质量。
共分析了39项研究，共有8186名参与者。护士、全科医生和专科医生是多学科团队中最常见的成员。人员配置模式、共享护理以及角色扩展或任务转移是最常见的多学科团队合作干预措施。叙述性综合分析显示，在自我管理、自我效能、满意度、健康行为和知识方面有所改善。荟萃分析发现，慢性阻塞性肺疾病患者的住院天数显著减少（MD=-0.66，95%CI -1.05至-0.26，I=0%），慢性心力衰竭患者的生活质量显著改善（MD=-4.63，95%CI：-8.67至-0.60，I=0%）。没有一致的证据表明存在其他此类效果指标。
多学科团队合作可以改善非医院环境中慢性病患者报告的结局，但对临床结局、医疗利用和成本的影响并不明显。
该研究方案于2019年1月21日在PROSPERO注册，注册号为CRD42019121109。
