A multidisciplinary approach for patients with multiple chronic conditions: IMPACTO study

Nieto-Martín, Maria Dolores; Higuera-Vila, L. de la; Bernabéu-Wittel, Máximo; González-Benitez, Maria Angeles; Alfaro-Lara, Eva Rocío; Barón-Ramos, Miguel Angel; Montero-Aparicio, Esperanza; Aparicio-Santos, Reyes; Baturone, Manuel Ollero; Martin, Mike; Wittel, Máximo Bernabéu; Benítez, Ángeles González; Ramos, Miguel Ángel Barón; Sanz, María del Val Martín; Ocaña, Javier; Morano, Juan Santos; Vila, Laura De la Higuera; Montero, Elena Paulino; Torres, Miguel Angel Díaz; Santos, Reyes Aparicio; Jiménez, María Maiz; Gómez, Manuel Asensio; Quiles, Carlos Hernández; Gómez, Carlos Palacios; García, José Alejandro Medina; Baturone, M.O.; Giraldo, Diana Mendoza; González, Carmen Aguilera; Ojeda, Rocío Fernández; Machín, José Manuel; Gaviño, Lourdes Moreno; Zafra, A Ruz; Sanchez, Guarionex Uribarri; Costa, Mariela Grana; Bailón, Manuel Méndez; Juliá, Aránzazu Pereira; Cobas, Carla Rivas; Vaz, Antonio Javier Vallejo; Navarro, Antonio Vicente Sempere; Rey, Jordi Forteza; Ferrer, Natalia Teresa Costa; Segovia, Julia Praena; Arraigosa, Antonio Albarracín; Murcia, José; Amado, Carolina Luque; Contreras, José Antonio Cuello; Guerrero, Monserrat Godoy; Fuentes, Daniel Vicente; Lara, Eva Alfaro; Coca, M Dolores Vega; Galván-Banqueri, Mercedes; Moyano, Antonio Fernández; Cantero, Alberto Ruiz; Santos-Ramos, Bernardo

doi:10.1016/j.medcle.2019.01.022

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…To our knowledge, no prior studies have systematically aligned outpatient appointments. Some interventions have provided care coordination [33] or involved multidisciplinary teams in the patient care [34][35][36][37]. An example is the Clinic for Multimorbidity at Silkeborg Regional Hospital, where patients are referred by the GP.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Coordinating the Outpatient Treatment across Medical Specialities for Patients With Multimorbidity

Bell,

Appel,

Prior

et al. 2024

Int J Integr Care

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Introduction: Patients with multimorbidity attend multiple outpatient clinics. We assessed the effects on hospital use of scheduling several outpatient appointments to same-day visits in a multidisciplinary outpatient pathway (MOP). Methods: This study used a quasi-experimental design. Eligible patients had multimorbidity, were aged ≥18 years and attended ≥2 outpatient clinics in five different specialties. Patients were identified through forthcoming appointments from August 2018 to March 2020 and divided into intervention group (alignment of appointments) and comparison group (no alignment). We used patient questionnaires and paired analyses to study care integration and treatment burden. Using negative binomial regression, we estimated healthcare utilisation as incidence rates ratios (IRRs) at one year before and one year after baseline for both groups and compared IRR ratios (IRRRs). Results: Intervention patients had a 19% reduction in hospital visits (IRRR: 0.81, 95% CI: 0.70–0.96) and a 17% reduction in blood samples (IRRR: 0.83, 0.73–0.96) compared to comparison patients. No effects were found for care integration, treatment burden, outpatient contacts, terminated outpatient trajectories, hospital admissions, days of admission or GP contacts. Conclusion: The MOP seemed to reduce the number of hospital visits and blood samples. These results should be further investigated in studies exploring the coordination of outpatient care for multimorbidity. Research question: Can an intervention of coordinating outpatient appointments to same-day visits combined with a multidisciplinary conference influence the utilisation of healthcare services and the patient-assessed integration of healthcare services and treatment burden among patients with multimorbidity?

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