Network of doctors for multimorbidity and diabetes - the NOMAD intervention: protocol for feasibility trial of multidisciplinary team conferences for people with diabetes and multimorbidity.

Autor: Bugge SJ; Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark. stinejorstad@gmail.com.; Department of Pharmacology, Odense University Hospital, Odense, Denmark. stinejorstad@gmail.com.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark. stinejorstad@gmail.com., Henriksen DP; Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark.; Department of Pharmacology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Damkier P; Department of Pharmacology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Rahbek MT; Department of Pharmacology, Odense University Hospital, Odense, Denmark.; Department of Public Health, University of Southern Denmark, Odense, Denmark., Schousboe K; Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Rothmann MJ; Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Poulsen MK; Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Hansen C; Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark., Nagarajah S; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Nephrology, Odense University Hospital, Odense, Denmark., Jensen PB; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Nephrology, Odense University Hospital, Odense, Denmark., Johansson SL; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark., Panou V; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark., Schneider IR; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Cardiology, Odense University Hospital, Odense, Denmark., Pedersen CG; Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark.; Department of Public Health, Aarhus University, Aarhus, Denmark., Andersen JD; Steno Diabetes Centre Northern Jutland, Aalborg University Hospital, Aalborg, Denmark.; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark., Hangaard J; Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Zwisler AO; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Cardiology, Odense University Hospital, Odense, Denmark.; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark.
Jazyk: angličtina
Zdroj: Pilot and feasibility studies [Pilot Feasibility Stud] 2024 Jun 15; Vol. 10 (1), pp. 91. Date of Electronic Publication: 2024 Jun 15.
DOI: 10.1186/s40814-024-01517-0
Abstrakt: 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.
Discussion: 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.
Administrative Information: Protocol version: 01 TRIAL REGISTRATION: NCT05913726 - registration date: 21 June 2023.
(© 2024. The Author(s).)
Databáze: MEDLINE
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