Perspectives of specialists and family physicians in interprofessional teams in caring for patients with multimorbidity: a qualitative study

Abstract

Background: Patients with multimorbidity often require services across different health care settings, yet team processes among settings are rarely implemented. We explored perceptions of specialists and family physicians collaborating in a telemedicine interprofessional consultation for patients with multimorbidity to better understand the value of bringing physicians together across the boundaries of health care settings. Methods: This was a descriptive qualitative, interview-based study. Physicians who had previously participated in the Telemedicine Interprofessional Model of Practice for Aging and Complex Treatments (Telemedicine IMPACT Plus [TIP] Program) were invited to participate and asked to describe their experience of being a member of the program. Interviews were conducted from March to May 2016. We conducted an iterative and interpretive process using both individual and team analysis to identify themes. Results: There were 15 participants, 9 specialists and 6 family physicians. Three themes emerged in the analysis: creating new perspectives on care for patients with multimorbidity by sharing knowledge, skills and attitudes; the shift from a consultant model to an interprofessional team model (allowing a window into the community, extending discussions beyond the medical model and focusing on the patient's health in context); and opportunities for learners, including learning about interprofessional collaboration and gaining exposure to a real-world model for caring for people with multimorbidity in outpatient settings. Interpretation: Family physicians and specialists participating in a TIP Program believed the program improved their knowledge and skills, while also serving as an effective care delivery strategy. The findings also support that learners require more exposure to nontraditional consultant models in order to care for patients with multimorbidity effectively.

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

“…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.…”

Longitudinal changes in blood pressure and fasting plasma glucose among 5,398 primary care patients with concomitant hypertension and diabetes: An observational study and implications for community-based cardiovascular prevention

“…Our findings provided evidence to fill in the gaps in understanding of whether multidisciplinary team-based primary care may overcome “clinical inertia” in the real-world setting. International experiences from Canada and Israel demonstrated that inter-professional teams could contribute to facilitating the transfer of knowledge, skills and attitudes, and thus are capable of enhancing clinical competencies and overcoming traditional barriers in the delivery of cardiovascular care ( 48 – 50 ). Alongside the transformation of practice paradigm to empower hypertensive patients with the coexistence of common long-term conditions such as T2DM, team-based educational programmes and tools that accommodate the needs of and provide support for underserved subpopulations might create opportunities to deepen patients' insights into the clustering of disease components and improve their intrinsic motivation to build self-management skills for cardiovascular health ( 51 , 52 ).…”

Perspectives on the popularization of smart senior care to meet the demands of older adults living alone in communities of Southwest China: A qualitative study

“…Continuous monitoring is crucial for those living alone, which allows for the provision of the unremitting health status of older adults (37), realizing early detection and diagnosis of diseases, and can improve the quality of life and reduce the waste of medical resources (38). Moreover, the combination of interprofessional teams and smart senior care enables primary care physicians, nurses, specialists, and other professionals to discuss together to handle elderly patients with multimorbidity without transferring them (39), while avoiding multiple outpatient appointments as well as preventing the spread of inadequate and conflicting information between medical staff (40).…”