An Overview of Reviews on Interprofessional Collaboration in Primary Care: Effectiveness.

Tania Carron,Christine Cohidon,Cloe Rawlinson,Quan Nha Hong,Isabelle Peytremann-Bridevaux,Ingrid Gilles,Pierre Pluye,Chantal Arditi

doi:10.5334/ijic.5588

Abstract

Introduction:Interprofessional collaboration (IPC) is increasingly used but diversely implemented in primary care. We aimed to assess the effectiveness of IPC in primary care settings.Methods:An overview (review of systematic reviews) was carried out. We searched nine databases and employed a double selection and data extraction method. Patient-related outcomes were categorized, and results coded as improvement (+), worsening (–), mixed results (?) or no change (0).Results:34 reviews were included. Six types of IPC were identified: IPC in primary care (large scope) (n = 8), physician-nurse in primary care (n = 1), primary care physician (PCP)-specialty care provider (n = 5), PCP-pharmacist (n = 3), PCP-mental healthcare provider (n = 15), and intersectoral collaboration (n = 2). In general, IPC in primary care was beneficial for patients with variation between types of IPC. Whereas reviews about IPC in primary care (large scope) showed better processes of care and higher patient satisfaction, other types of IPC reported mixed results for clinical outcomes, healthcare use and patient-reported outcomes. Also, reviews focusing on interventions based on pre-existing and well-defined models, such as collaborative care, overall reported more benefits. However, heterogeneity between the included primary studies hindered comparison and often led to the report of mixed results. Finally, professional- and organizational-related outcomes were under-reported, and cost-related outcomes showed some promising results for IPC based on pre-existing models; results were lacking for other types.Conclusions:This overview suggests that interprofessional collaboration can be effective in primary care. Better understanding of the characteristics of IPC processes, their implementation, and the identification of effective elements, merits further attention.

Highlights

Interprofessional collaboration (IPC) is increasingly used but diversely implemented in primary care
SYNTHESIS OF RESULTS Reviews were firstly categorized according to the type of IPC targeted by the review, in terms of setting and type of healthcare professionals involved, as defined by the authors of the review
We synthesized the results by aggregating them according to six broad categories of patient outcomes: clinical outcomes, medication outcomes, healthcare use, processes of care, quality of life (QoL), functioning, other patient-reported outcome measures, and patient satisfaction (Table 1)

Summary

Introduction

Interprofessional collaboration (IPC) is increasingly used but diversely implemented in primary care. Due to the growing burden of chronic diseases and aging populations, primary care is facing an increasing number of patients with complex needs, requiring comprehensive, continuous and coordinated care with a variety of healthcare professionals. In response to this burden, new models of care, including interprofessional collaboration (IPC), have been recommended in primary care [1]. As the interest in IPC is growing in primary care, an understanding of its effectiveness, implementation processes and mechanisms is necessary

Objectives

Methods

Results

Discussion

Conclusion