多学科团队在糖尿病和合并症患者的诊断和治疗:范围审查。

Jonas Dahl Andersen, Morten Hasselstrøm Jensen, Peter Vestergaard, Vigga Jensen, Ole Hejlesen, Stine Hangaard
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摘要

背景:多学科团队(MDTs)已被建议作为一种干预措施,以克服糖尿病患者在诊断和治疗方面所经历的一些复杂性和合并症。然而,在糖尿病领域,关于mdt的证据仍然很少。目的:本综述旨在识别和绘制关于MDTs在糖尿病和合并症患者诊断和治疗背景下的关键特征的现有证据。方法:本综述遵循PRISMA-ScR指南。系统检索PubMed、EMBASE和CINAHL数据库,以评估成人(≥18岁)糖尿病和合并症/并发症的诊断和治疗背景下任何类型MDT的研究。数据提取包括研究特征、MDT干预、数字健康解决方案和主要发现的详细信息。结果:共纳入19项研究。总体而言,mdt具有高度异质性。mdt有四个总体组成部分:不同团队规模的医学专家和医疗保健专业人员(HCPs)都有代表;干预措施包括药物治疗、评估、营养、教育、自我监测和治疗调整;58%的研究纳入了数字健康解决方案;在初级和二级卫生保健机构以不同的频率进行了mdt。一般来说,MDTs的有效性在不同的结果中都是积极的。结论:MDTs的特点是其大纲高度多样化,但在糖尿病和合并症患者的诊断和治疗方面似乎是有效和具有成本效益的。未来的研究应探讨跨部门合作,以减少护理碎片化,加强护理协调。
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The multidisciplinary team in diagnosing and treatment of patients with diabetes and comorbidities: A scoping review.

Background: Multidisciplinary Teams (MDTs) has been suggested as an intervention to overcome some of the complexities experienced by people with diabetes and comorbidities in terms of diagnosis and treatment. However, evidence concerning MDTs within the diabetes field remains sparse.

Objective: This review aims to identify and map available evidence on key characteristics of MDTs in the context of diagnosis and treatment in people with diabetes and comorbidities.

Methods: This review followed the PRISMA-ScR guidelines. Databases PubMed, EMBASE, and CINAHL were systematically searched for studies assessing any type of MDT within the context of diagnosis and treatment in adult people (≥ 18 years) with diabetes and comorbidities/complications. Data extraction included details on study characteristics, MDT interventions, digital health solutions, and key findings.

Results: Overall, 19 studies were included. Generally, the MDTs were characterized by high heterogeneity. Four overall components characterized the MDTs: Both medical specialists and healthcare professionals (HCPs) of different team sizes were represented; interventions spanned elements of medication, assessment, nutrition, education, self-monitoring, and treatment adjustment; digital health solutions were integrated in 58% of the studies; MDTs were carried out in both primary and secondary healthcare settings with varying frequencies. Generally, the effectiveness of the MDTs was positive across different outcomes.

Conclusions: MDTs are characterized by high diversity in their outline yet seem to be effective and cost-effective in the context of diagnosis and treatment of people with diabetes and comorbidities. Future research should investigate the cross-sectorial collaboration to reduce care fragmentation and enhance care coordination.

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