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Published in: International Urogynecology Journal 6/2020

01-06-2020 | Care | Original Article

Evidence for the urogynaecology multidisciplinary team meeting: evaluation from a secondary care perspective

Authors: Keren E. Wales, Anupama Saxena, Thomas G. Gray

Published in: International Urogynecology Journal | Issue 6/2020

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Abstract

Introduction

Urogynaecology multidisciplinary team (MDT) meetings to discuss management plans prior to invasive treatments for urinary incontinence have been recommended by guidelines in the UK since 2013. Evidence for MDT discussion in urogynaecology is lacking, with only two published studies. The aim of this study was to evaluate the cases discussed at a secondary care urogynaecology MDT meeting, to establish types of clinical problems discussed, assess the outcomes of the MDT meeting and compare this with existing evidence for MDT meetings in urogynaecology.

Methods

A retrospective review of meeting minutes and all case notes for patients discussed at 12 MDT meetings over 13 months was carried out. Data collected included attendance from different staff groups, reasons for referral, outcome of discussions, and changes to management plans.

Results

A total of 123 cases were discussed over 12 meetings, 7 members of staff attended each meeting on average. 63% of cases were referred for discussion of a primary problem. The majority of patients were referred for discussion of management of urinary incontinence prior to invasive procedures (57%). The agreed MDT plan corresponded with proposed management in 67% of cases, with changes to management plan in 31% of cases.

Conclusion

Refinements to management plans in this study highlight the importance of MDT input in urogynaecology care and mirror the findings of two previous studies. Evidence for improved outcomes and the cost-effectiveness of MDTs is lacking and is an area for future research. Expanded national guidance for urogynaecology MDTs is likely to require local and regional restructuring of these in the UK.
Literature
1.
go back to reference Expert Advisory Group on Cancer. A policy framework for commissioning cancer services: a report to the chief medical officer of England and Wales. The Calman–Hine Report. London: Department of Health; 1995. Expert Advisory Group on Cancer. A policy framework for commissioning cancer services: a report to the chief medical officer of England and Wales. The Calman–Hine Report. London: Department of Health; 1995.
2.
go back to reference Munro A, Brown M, Niblock P, Steele R, Carey F. Do multidisciplinary team (MDT) processes influence survival in patients with colorectal cancer? A population-based experience. BMC Cancer. 2015;15:686.CrossRef Munro A, Brown M, Niblock P, Steele R, Carey F. Do multidisciplinary team (MDT) processes influence survival in patients with colorectal cancer? A population-based experience. BMC Cancer. 2015;15:686.CrossRef
3.
go back to reference MacDermid E, Hooton G, MacDonald M, McKay G, Grose D, Mohammed N, et al. Improving patient survival with the colorectal cancer multi-disciplinary team. Colorectal Dis. 2009;11(3):291–29.CrossRef MacDermid E, Hooton G, MacDonald M, McKay G, Grose D, Mohammed N, et al. Improving patient survival with the colorectal cancer multi-disciplinary team. Colorectal Dis. 2009;11(3):291–29.CrossRef
4.
go back to reference Bydder S, Nowak A, Marion K, Phillips M, Atun R. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Intern Med J. 2009;12:838–41.CrossRef Bydder S, Nowak A, Marion K, Phillips M, Atun R. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Intern Med J. 2009;12:838–41.CrossRef
6.
go back to reference Kesson EM, Allardice GM, George WD, Burns HJG, Morrison DS. Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ. 2012;344:e2718.CrossRef Kesson EM, Allardice GM, George WD, Burns HJG, Morrison DS. Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ. 2012;344:e2718.CrossRef
7.
go back to reference Hong NJ, Wright FC, Gagliardi AR, Paszat LF. Examining the potential relationship between multidisciplinary cancer care and patient survival: an international literature review. J Surg Oncol. 2010;102(2):125–34.CrossRef Hong NJ, Wright FC, Gagliardi AR, Paszat LF. Examining the potential relationship between multidisciplinary cancer care and patient survival: an international literature review. J Surg Oncol. 2010;102(2):125–34.CrossRef
8.
go back to reference Pillay B, Wooten AC, Crowe H, Corcoran N, Tran B, Bowden P, et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: a systematic review of the literature. Cancer Treat Rev. 2016;42:56–72.CrossRef Pillay B, Wooten AC, Crowe H, Corcoran N, Tran B, Bowden P, et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: a systematic review of the literature. Cancer Treat Rev. 2016;42:56–72.CrossRef
9.
go back to reference Wright A, Helm J, Spencer L, Leonard C, Bishop P, Greaves M, et al. S12 interstitial lung disease multidisciplinary discussion: six years of data from a tertiary service. Thorax. 2013;68:A9–A10.CrossRef Wright A, Helm J, Spencer L, Leonard C, Bishop P, Greaves M, et al. S12 interstitial lung disease multidisciplinary discussion: six years of data from a tertiary service. Thorax. 2013;68:A9–A10.CrossRef
10.
go back to reference Morar P, Read J, Arora S, Hart A, Warusavitarne J, Green J, et al. Defining the optimal design of the inflammatory bowel disease multidisciplinary team: results from a multicentre qualitative expert-based study. Frontline Gastroenterol 2015;6:290–7.CrossRef Morar P, Read J, Arora S, Hart A, Warusavitarne J, Green J, et al. Defining the optimal design of the inflammatory bowel disease multidisciplinary team: results from a multicentre qualitative expert-based study. Frontline Gastroenterol 2015;6:290–7.CrossRef
14.
go back to reference Adorian D, Silverberg DS, Tomer D, Wasmosher Z. Group discussions with the health care team – a method of improving care of hypertension in general practice. J Hum Hypertens. 1990;4(3):265–8.PubMed Adorian D, Silverberg DS, Tomer D, Wasmosher Z. Group discussions with the health care team – a method of improving care of hypertension in general practice. J Hum Hypertens. 1990;4(3):265–8.PubMed
15.
go back to reference Sim TA, Joyner J. A multidisciplinary team approach to reducing medication variance. Jt Comm J Qual Improv. 2002;28(7):403–9.PubMed Sim TA, Joyner J. A multidisciplinary team approach to reducing medication variance. Jt Comm J Qual Improv. 2002;28(7):403–9.PubMed
16.
go back to reference Caplan GA, Williams AJ, Daly B, Abraham K. A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly patients in an emergency department—the DEED II study. J Am Geriatr Soc. 2004;52(9):1417–23.CrossRef Caplan GA, Williams AJ, Daly B, Abraham K. A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly patients in an emergency department—the DEED II study. J Am Geriatr Soc. 2004;52(9):1417–23.CrossRef
17.
go back to reference McAlister FA, Stewart S, Ferrua S, McMurray JJJV. Multidisciplinary strategies for the management of heart failure patients at high risk for admission. J Am Coll Cardiol. 2004;44(4):810–9.PubMed McAlister FA, Stewart S, Ferrua S, McMurray JJJV. Multidisciplinary strategies for the management of heart failure patients at high risk for admission. J Am Coll Cardiol. 2004;44(4):810–9.PubMed
18.
go back to reference Firdaus M, Elzubier M, Majumdar D, Greenaway J. Role of MDT in management of benign HPB disease-experience from a non-HPB centre in UK. Gut. 2018;67:A236–7. Firdaus M, Elzubier M, Majumdar D, Greenaway J. Role of MDT in management of benign HPB disease-experience from a non-HPB centre in UK. Gut. 2018;67:A236–7.
23.
go back to reference Pandeva I, Biers S, Pradhan A, Verma V, Slack M, Thiruchelvam N. The impact of pelvic floor multidisciplinary team on patient management: the experience of a tertiary unit. J Multidiscip Healthc. 2019;12:205–10.CrossRef Pandeva I, Biers S, Pradhan A, Verma V, Slack M, Thiruchelvam N. The impact of pelvic floor multidisciplinary team on patient management: the experience of a tertiary unit. J Multidiscip Healthc. 2019;12:205–10.CrossRef
24.
go back to reference Jha S, Cutner A, Moran P. The UK national prolapse survey: 10 years on. Int Urogynecol J. 2018;29(6):795–801.CrossRef Jha S, Cutner A, Moran P. The UK national prolapse survey: 10 years on. Int Urogynecol J. 2018;29(6):795–801.CrossRef
25.
go back to reference Lamb BW, Brown KF, Nagpal K, Vincent C, Green JSA, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18:2116.CrossRef Lamb BW, Brown KF, Nagpal K, Vincent C, Green JSA, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18:2116.CrossRef
26.
go back to reference Balachandran A, Monga A, Duckett J. Management of female urinary incontinence: a survey of urogynaecologists’ view on the NICE guideline. J Obstet Gynaecol. 2016;36(4):487–91.CrossRef Balachandran A, Monga A, Duckett J. Management of female urinary incontinence: a survey of urogynaecologists’ view on the NICE guideline. J Obstet Gynaecol. 2016;36(4):487–91.CrossRef
27.
go back to reference Raine R, Wallace I, Nic A, Bháird C, Xanthopoulou P, Lanceley A, et al. Improving the effectiveness of multidisciplinary team meetings for patients with chronic diseases: a prospective observational study. Southampton, UK: NIHR Journals Library; 2014. Raine R, Wallace I, Nic A, Bháird C, Xanthopoulou P, Lanceley A, et al. Improving the effectiveness of multidisciplinary team meetings for patients with chronic diseases: a prospective observational study. Southampton, UK: NIHR Journals Library; 2014.
28.
go back to reference Ke MK, Blazeby JM, Strong S, Carroll FE, Ness AR, Hollingworth W. Are multidisciplinary teams in secondary care cost effective? A systematic review of the literature. Cost Eff Resour Alloc. 2013;11:7.CrossRef Ke MK, Blazeby JM, Strong S, Carroll FE, Ness AR, Hollingworth W. Are multidisciplinary teams in secondary care cost effective? A systematic review of the literature. Cost Eff Resour Alloc. 2013;11:7.CrossRef
Metadata
Title
Evidence for the urogynaecology multidisciplinary team meeting: evaluation from a secondary care perspective
Authors
Keren E. Wales
Anupama Saxena
Thomas G. Gray
Publication date
01-06-2020
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 6/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-019-04154-x

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