Multidisciplinary team approach to diabetes. An outlook on providers’ and patients’ perspectives

Tan, Hon Qin Marcus; Chin, Yip Han; Ng, Cheng Han; Liow, Yiyang; Khoo, Chin Meng; Goh, Lay Hoon

doi:10.1016/j.pcd.2020.05.012

Cited by 25 publications

(17 citation statements)

References 33 publications

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“…However, when we evaluate the competencies of the clinical staff for each type of healthcare, the differences are much smaller, although in general terms the scores remain low for the two models of care. These levels of e ciency and quality of care are consistent with those found in other studies (Codispoti et al 2004;Tan et al 2020), where they nd greater e ciency and quality in multidisciplinary teams compared to traditional teams in the context of caring for diabetic patients.…”

Section: Discussionsupporting

confidence: 90%

Efficiency, quality, and management practices in multidisciplinary and traditional diabetes healthcare services in Mexico

Chivardi

Sosa

Galárraga

et al. 2023

Preprint

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This study determined the efficiency of two different models of diabetes care (traditional units and multidisciplinary units), estimated quality levels, and identified management practices associated with better quality and efficiency of both models in Mexico. A random sample consisting of 40 units (20 for each type of unit), allowed us to estimate technical efficiency using data envelopment analysis (DEA) after we calculated quality scores (performance and competence). We mapped the relationship between efficiency and quality score, and using a positive deviance approach, we studied managerial determinants of best performance in terms of both efficiency and quality. We found that efficiency in multidisciplinary units was higher than in traditional units; traditional units scored very low in terms of efficiency. Likewise, in terms of the different quality metrics, the multidisciplinary units were much better evaluated than the traditional units. We found important differences in the quality scores for the different health care models. Two-thirds of the multidisciplinary units were in the best-performing group (above-median efficiency and above-median performance), and almost half of them were mapped to the high-competence quadrant. On the other hand, only 10% of the traditional units managed to position themselves in the best performance quadrant. Managerial characteristics were positively correlated with the probability of belonging to the group with the highest performance. Our findings indicate that multidisciplinary medical care can lead to better outcomes for patients with diabetes compared to traditional medical care. In both types of units, however, there is substantial opportunity to improve efficiency and quality levels.

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Section: Discussionsupporting

confidence: 90%

Efficiency, quality, and management practices in multidisciplinary and traditional diabetes healthcare services in Mexico

Chivardi

Sosa

Galárraga

et al. 2023

Preprint

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“…8 T2DM is a chronic condition that necessitates continual interdisciplinary cooperation and patient self-management. 9 To address a person's health needs, healthcare services are provided and coordinated through a collaborative process called case management. 10 The case manager-led Multi-Disciplinary Team (MDT) approach has been implemented in many countries faced with an increasing burden of caring costs for an increasing population with chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Case Manager Led Multi-Disciplinary Team Approach on Glycemic Control Amongst T2DM Patients in Primary Care in Riyadh: A Retrospective Follow-Up Study

Alshowair,

Altamimi,

Alshahrani

et al. 2023

J Prim Care Community Health

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Objectives: Our study aims to assess the effectiveness of implementing a case manager-led Multidisciplinary Team approach in the primary healthcare setting on improving glycemic control and reducing cardiovascular risks for T2DM patients over a 6-month period. Methods: This retrospective record-based follow-up study was carried out on 3060 uncontrolled T2DM patients in primary healthcare centers in Riyadh First Health Cluster over a period of 6 months. The patient records are investigated and analyzed, including demographic characteristics and measurements of Hemoglobin A1c (HbA1c), Low-Density Lipoprotein Cholesterol (LDL-C), total cholesterol, and BP levels at enrollment and after 6 months of Multi-Disciplinary Team follow-up. The changes in the study variables and their correlations to each other are tested using Statistical Package for the Social Sciences software. Results: At enrollment, our patients were characterized by poor glycemic control (HbAIC > 8%). Most of them have high body weight with a mean BMI of (31.2 ± 1.7), and nearly two-thirds are either hypertensive or have dyslipidemia (43.4% and 47.3% respectively). After 6 months of MDT follow-up, there is a significant improvement in glycemic control among 1971 patients (64.4%), with a reduction in the mean level of different outcomes relative to baseline HbA1c (−15%, P < .001), total cholesterol (−9.0%, P < .001), LDL-C (−11.0%, P < .001), systolic BP (−7.7%, P < .001), and diastolic BP (−10.5%, P < .001). The improved glycemic control showed a significant positive correlation with the number of MDT visits but negatively correlated with BMI and the number of comorbidities. In addition, the improvements in secondary outcomes were positively and significantly correlated with such improvements in glycemic control. Conclusion: Case-manager-led MDT approach significantly improves glycemic control and significantly improves control over dyslipidemia and hypertension, reducing cardiovascular risks, and unfavorable events among such diabetic patients. We highly recommend developing more MDTs, training case managers, and rigorously evaluating the MDT approach.

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“…This study found that 73.9% of the participants had multimorbidity, which presented challenges for their self-management due to conflicting treatment regimens and issues of polypharmacy. Although current evidence favors a multidisciplinary team approach to provide self-management education to patients with T2DM, 23 the considerable time, effort, and financial resources required for health care professionals to implement multidisciplinary team meetings limit the accessibility of such services. 24 In addition, this study found that older adults with T2DM often struggle with lower-limb function decline and pain, which limits their capacity to follow exercise programs prescribed for glycemic control.…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators of Self-Management for Older Adults Living With Type 2 Diabetes Mellitus: A Qualitative Study in China

Wu,

Xu,

Cao

et al. 2024

The Science of Diabetes Self-Management and Care

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Purpose: The purpose of the study was to explore the barriers to and facilitators of self-management among older adults with type 2 diabetes mellitus (T2DM). Methods: This study followed a qualitative descriptive methodology. Older adults with T2DM living in Jinan, Shandong Province, China were recruited using purposive sampling. Information saturation was used to gauge the sample size. Semistructured interviews were conducted with 23 participants. The data analysis was guided using a thematic approach. Themes were inducted from the interview data undergirded by the cumulative complexity model. Results: The key findings of this study are presented in terms of 2 themes: facilitators of T2DM self-management and barriers to T2DM self-management. Each theme has subthemes, including that having family members with diabetes, having family members who are health care professionals, and visual cues were factors for good self-management practices by older adults with T2DM. Conversely, poor health status (ie, multimorbidity and lower-limb dysfunction and pain) and intergenerational care responsibilities were identified as barriers to effective self-management. Moreover, the use of media resources, especially traditional media, was found to both assist and hinder participants in their self-management practices. Conclusion: The findings from this study can inform new research to build on existing self-management promotion programs and restructure existing services to improve the self-management of older adults with T2DM. With the increase in the number and types of media outlets, our finding implies that researchers or clinical practitioners may develop strategies to leverage media resources to enhance the self-management of diabetes among older adults with T2DM.

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Multidisciplinary team approach to diabetes. An outlook on providers’ and patients’ perspectives

Cited by 25 publications

References 33 publications

Efficiency, quality, and management practices in multidisciplinary and traditional diabetes healthcare services in Mexico

Efficiency, quality, and management practices in multidisciplinary and traditional diabetes healthcare services in Mexico

Effectiveness of Case Manager Led Multi-Disciplinary Team Approach on Glycemic Control Amongst T2DM Patients in Primary Care in Riyadh: A Retrospective Follow-Up Study

Barriers and Facilitators of Self-Management for Older Adults Living With Type 2 Diabetes Mellitus: A Qualitative Study in China

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