Dr Gayani Amarasinghe1, Dr Sucharitha Weerasooriya1, Dr. Christina Malatzky4, Dr. Sanjeewa Kularatna1,2, Prof. William Parsonage1,3
1Australian Centre for Health Service Innovation (AusHI), Faculty of public health and social work, Queensland University of Technology, Kelvin Grove, Australia, 2Health Services and Systems Research, Duke-NUS Medical School, , Singapore, 3Royal Brisbane and Womens Hospital, Brisbane, Australia, 4School of Health, Queensland University of Technology, Kelvin Grove, Australia
Biography:
The presenting author is a PhD student at Queensland University of Technology. She has worked as a public health physician in Sri Lanka and has a strong research focus on maternal and perinatal health, including peripartum depression, maternal anaemia, and heart diseases in pregnancy.
Abstract:
Many national and international guidelines recognise the importance of multidisciplinary care for pregnant women with comorbid chronic diseases but often do not provide guidance on operationalising multidisciplinary care provision. A systematic review was undertaken to fill this gap by identifying methods currently used to deliver multidisciplinary care. However, inconsistencies in aspects reported in papers describing multidisciplinary care models were observed to make understanding their operationalisation difficult. So, a conceptual framework was developed for describing multidisciplinary care models for complicated pregnancies.
PubMed/Medline, Embase and CINAHL databases were searched for English-language papers published in the last decade describing multidisciplinary care models for pregnancies complicated with chronic diseases. Two researchers independently reviewed the titles and abstracts of papers generated through the search, and the full text of selected papers was reviewed to identify potential inclusions. Case reports, study protocols, and non-primary studies were excluded. The quality of reporting the model was assessed based on the template for intervention description and replication checklist. Extracted data was categorised inductively, and the conceptual framework was designed.
Out of 6062 title and abstract screened articles, 814 were selected for the full-text review from which 58 were selected for data extraction. Overall quality of reporting the model was moderate in most papers. The conceptual framework identified three areas for describing multidisciplinary care models: multidisciplinary care delivery (the team, patterns of communication and decision-making), the context of the model (locations of disciplines, the number and the reach of patients, funding and administrative arrangements and the guidelines and policies supporting the model); and the evolution of the model (how the model was developed, monitoring and evaluation arrangements, and how the model was modified overtime). This conceptual framework can support researchers to describe multidisciplinary care models uniformly and comprehensively, allowing their reproducibility in different contexts to be understood and compared.
Keywords
multidisciplinary care models, chronic diseases, systematic review
References
Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014 Mar 7;348(mar07 3):g1687–g1687.