Evidence for the role of multidisciplinary team care in people with pelvic pain and endometriosis: A systematic review

Abstract

BackgroundEndometriosis is a chronic, inflammatory condition characterised by the presence of endometrial‐like tissue outside the uterine cavity. Given the multi‐system nature of the disease and the potential for significant negative impact on quality of life, there has been a long‐standing recognition of the need for multidisciplinary care for people with endometriosis. However, there is paucity to the data supporting this approach, and much of the evidence is anecdotal.AimThis systematic review aims to describe recent evidence‐based models and patient‐centred perspectives of multidisciplinary care for endometriosis, to improve understanding of the role of an integrated, multidisciplinary team in effectively addressing patients' care needs.Materials and MethodsPubMed, Medline, Embase and Web of Science were searched for relevant articles published between 1 January 2010 to 7 July 2022.ResultsNineteen studies met the inclusion and exclusion criteria and pinpointed a multidisciplinary team consisting of gynaecologists, pain specialists, nurses, physiotherapists, psychologists, sex therapists, nutritionists, complementary medicine practitioners, and social workers to be most commonly utilised in holistically managing people with pelvic pain and endometriosis. Furthermore, patient perspectives on care highlighted the need for reliable information, respect and validation of experiences or preferences, discussion of long‐term treatment plans and social and emotional supports.ConclusionThe trend for multidisciplinary team care for people with endometriosis is growing. Further consumer‐driven clinical studies and outcome evaluations need to be conducted to determine the effect of multidisciplinary care on improvements to quality of life for people living with endometriosis and or pelvic pain.

Perceived challenges in treatment decision-making for endometriosis: healthcare professional perspectives

“…The alternative voice was an allied HP who reported their clients wanted endometriosis to be treated more holistically, taking all symptoms into account simultaneously. There is growing recognition of the need for multidisciplinary endometriosis care (Fang et al, 2024 ; Mechsner, 2023 ), with one qualitative study reporting that the lack of a holistic approach contributed to low satisfaction with symptom management in PLWE (Evans et al, 2022 ). However, the nature of endometriosis and its treatments necessitates a level of priority setting, depending on primary goals.…”

“…Nevertheless, as understanding of the systemic nature of endometriosis develops (Taylor, 2019 ; Taylor et al, 2021 ), it is increasingly being recognised that PLWE need regimens that treat the condition as a whole rather than focusing on individual symptoms. This requires multidisciplinary teams that include allied health and complementary medicine practitioners alongside medical doctors such as GPs and obstetrician-gynaecologists (Agarwal et al, 2019 ; Fang et al, 2024 ).…”