Experience of patients and healthcare practitioners with interdisciplinary care in immune-mediated inflammatory diseases with skin manifestations: A systematic scoping review.

Abstract

Immune-mediated inflammatory diseases with skin manifestations (skIMIDs) may affect multiple organs. Interdisciplinary care (IC) can overcome the fragmented knowledge used in the management of skIMIDs. In skIMIDs-care, patient and healthcare practitioner (HCP) satisfaction with IC is unknown. Yet, patient experience influences adherence and medical outcomes. Moreover, HCP experience influences professional satisfaction, perception of care quality and autonomy. Thus, measuring patient and HCP experience can identify areas for improvement in care delivery. The aim of this scoping review was to gather evidence on patient- and HCP perceptions on skIMID-IC and their measurement. We systematically searched on 30 August 2023 PubMed/EMBASE/Cinahl/Web of Science. Eligible studies had to address explicitly experience of IC by patients or HCPs. A conceptional synthesis appraised how experiences were measured and IC was perceived by patients and HCPs. The database search resulted in 21 eligible studies. Fourteen described positive patient and HCP experiences with a specific IC programme. These studies were heterogenous on the levels of IC models, medical conditions, measurement methods and outcomes. Despite that patients and HCPs rated such tailored IC models positively, seven studies on a geographically broader region reported less satisfaction with IC. A conceptual analysis identified domains deemed as important regarding IC: 'general satisfaction', 'patient-HCP interaction', 'information', 'functioning of IC', 'benefits of IC'. For patients, 'access to care' and 'disease management' were added. For HCPs 'illness perception' was deemed relevant. The heterogeneous way in how IC experience is captured hinders strong conclusions, which mandates the development of standardized analysis tools. Experience with IC in skIMIDs strongly depends on the context of the provided IC and patient experience seems to be better in local IC programmes than systems rolled out in larger geographical regions. Future need is to develop a core IC outcome set including medical outcomes, process indicators, financial indicators, plus patient and HCP care experience measures.