Patient-initiated multidisciplinary teams: addressing complex care challenges and enhancing daily life - a qualitative study.

backgroundPatients with multimorbidity often encounter complex care needs. Steno Diabetes Center Aarhus introduced a novel approach: enabling patients to initiate Multidisciplinary Team (MDT) conferences with specialists. This study explores daily challenges in complex care and compares them between MDT initiators and non-initiators.

methodsAmong 4189 patients from the diabetes clinic who received an invitation about the intervention, 14 MDT initiators and 28 non-initiators were recruited from this larger pool for qualitative interviews conducted between 2022 and 2023. The research methodology employed Interpretive Description Methodology, with Aaron Antonovsky’s Sense of Coherence theory as the theoretical lens.

resultsFew patients initiated the MDT, with most non-initiators considering it irrelevant. MDT initiators expressed greater concerns about polypharmacy and experienced more pronounced symptoms of fatigue, physical pain, and psychological distress. However, no considerable differences were found in physical limitations and perceived well-being between the two groups. Both faced challenges managing chronic illnesses and uncoordinated schedules.

conclusionsNotable differences exist between MDT initiators and non-initiators, with initiators demonstrating heightened awareness of daily care complexities. This suggests promising results for patients with complex care needs to engage with a multidisciplinary team, discuss a coordinated care plan, and improve self-management. However, further research is needed on non-initiators, who constitute a substantial portion of our study population, to identify those who may benefit from enhanced, cross-departmental coordination to cope with the daily challenges of chronic illness.