PDF(Pubmed)
Abstract：
BACKGROUND: The prevalence of diabetes and coexisting multimorbidity rises worldwide. Treatment of this patient group can be complex. Providing an evidence-based, coherent, and patient-centred treatment of patients with multimorbidity poses a challenge in healthcare systems, which are typically designed to deliver disease-specific care. We propose an intervention comprising multidisciplinary team conferences (MDTs) to address this issue. The MDT consists of medical specialists in five different specialities meeting to discuss multimorbid diabetes patients. This protocol describes a feasibility test of MDTs designed to coordinate care and improve quality of life for people with diabetes and multimorbidity.
METHODS: A mixed-methods one-arm feasibility test of the MDT. Feasibility will be assessed through prospectively collected data. We will explore patient perspectives through patient-reported outcomes (PROs) and assess the feasibility of electronic questionnaires. Feasibility outcomes are recruitment, PRO completion, technical difficulties, impact of MDT, and doctor preparation time. During 17 months, up to 112 participants will be recruited. We will report results narratively and by the use of descriptive statistics. The collected data will form the basis for a future large-scale randomised trial.
CONCLUSIONS: A multidisciplinary approach focusing on better management of diabetic patients suffering from multimorbidity may improve functional status, quality of life, and health outcomes. Multimorbidity and diabetes are highly prevalent in our healthcare system, but we lack a solid evidence-based approach to patient-centred care for these patients. This study represents the initial steps towards building such evidence. The concept can be efficiency tested in a randomised setting, if found feasible to intervention providers and receivers. If not, we will have gained experience on how to manage diabetes and multimorbidity as well as organisational aspects, which together may generate hypotheses for research on how to handle multimorbidity in the future.
UNASSIGNED: Protocol version: 01 TRIAL REGISTRATION: NCT05913726 - registration date: 21 June 2023.
METHODS: A mixed-methods one-arm feasibility test of the MDT. Feasibility will be assessed through prospectively collected data. We will explore patient perspectives through patient-reported outcomes (PROs) and assess the feasibility of electronic questionnaires. Feasibility outcomes are recruitment, PRO completion, technical difficulties, impact of MDT, and doctor preparation time. During 17 months, up to 112 participants will be recruited. We will report results narratively and by the use of descriptive statistics. The collected data will form the basis for a future large-scale randomised trial.
CONCLUSIONS: A multidisciplinary approach focusing on better management of diabetic patients suffering from multimorbidity may improve functional status, quality of life, and health outcomes. Multimorbidity and diabetes are highly prevalent in our healthcare system, but we lack a solid evidence-based approach to patient-centred care for these patients. This study represents the initial steps towards building such evidence. The concept can be efficiency tested in a randomised setting, if found feasible to intervention providers and receivers. If not, we will have gained experience on how to manage diabetes and multimorbidity as well as organisational aspects, which together may generate hypotheses for research on how to handle multimorbidity in the future.
UNASSIGNED: Protocol version: 01 TRIAL REGISTRATION: NCT05913726 - registration date: 21 June 2023.
摘要：
背景：糖尿病和多重性并存的患病率在全球范围内上升。该患者组的治疗可能很复杂。提供基于证据的，连贯,以患者为中心的多病患者的治疗在医疗保健系统中构成了挑战，通常旨在提供针对疾病的护理。我们提出了一个由多学科团队会议（MDT）组成的干预措施来解决这个问题。MDT由五个不同专业的医学专家组成，会议讨论多糖尿病患者。该协议描述了MDT的可行性测试，旨在协调护理并提高糖尿病和多病患者的生活质量。
方法：MDT的混合方法单臂可行性测试。可行性将通过前瞻性收集的数据进行评估。我们将通过患者报告的结果（PRO）探索患者的观点，并评估电子问卷的可行性。可行性结果是招聘，PRO完成,技术难题,MDT的影响，和医生准备时间。在17个月中,将招募多达112名参与者。我们将通过叙述和使用描述性统计数据来报告结果。收集的数据将成为未来大规模随机试验的基础。
结论：多学科方法专注于更好地管理患有多种疾病的糖尿病患者可能会改善功能状态，生活质量,和健康结果。多症和糖尿病在我们的医疗系统中非常普遍，但对于这些患者,我们缺乏以患者为中心的治疗方法.这项研究代表了建立此类证据的初步步骤。该概念可以在随机设置中进行效率测试，如果发现对干预提供者和接受者可行。如果不是,我们将获得如何管理糖尿病和多发病率以及组织方面的经验，它们一起可以为未来如何处理多发病率的研究提供假设。
■协议版本：01审判注册：NCT0597726-注册日期：2023年6月21日。
方法：MDT的混合方法单臂可行性测试。可行性将通过前瞻性收集的数据进行评估。我们将通过患者报告的结果（PRO）探索患者的观点，并评估电子问卷的可行性。可行性结果是招聘，PRO完成,技术难题,MDT的影响，和医生准备时间。在17个月中,将招募多达112名参与者。我们将通过叙述和使用描述性统计数据来报告结果。收集的数据将成为未来大规模随机试验的基础。
结论：多学科方法专注于更好地管理患有多种疾病的糖尿病患者可能会改善功能状态，生活质量,和健康结果。多症和糖尿病在我们的医疗系统中非常普遍，但对于这些患者,我们缺乏以患者为中心的治疗方法.这项研究代表了建立此类证据的初步步骤。该概念可以在随机设置中进行效率测试，如果发现对干预提供者和接受者可行。如果不是,我们将获得如何管理糖尿病和多发病率以及组织方面的经验，它们一起可以为未来如何处理多发病率的研究提供假设。
■协议版本：01审判注册：NCT0597726-注册日期：2023年6月21日。
