Concept Of Multidisciplinary Team Research Articles

The general practitioner in charge of addictive behavior

IntroductionRecent reports confirmed that more than 22% of adult world population are suffering from addiction. Tobacco and alcohol use remain the most prevalent addictive behaviors reported in Tunisia. The management of addiction is a multidisciplinary team concept. This entity may be underdiagnosed due to perception default at the first line of management.The aim of this study was to identify the limiting factors for addictive behavior approach in general practitioner (GP) clinic.Recent reports confirmed that more than 22% of adult world population are suffering from addiction. Tobacco and alcohol use remain the most prevalent addictive behaviors reported in Tunisia. The management of addiction is a multidisciplinary team concept. This entity may be underdiagnosed due to perception default at the first line of management.ObjectivesThe aim of this study was to identify the limiting factors for addictive behavior approach in general practitioner (GP) clinic.MethodsA cross-sectional study involved 84 GPs in the city of Monastir, Tunisia. Self‐reported questionnaire was designed to survey the prevalence of patients with detectable addictive behavior among the outpatient GP clinic visitors.ResultsThe participation rate was 93.3% (84/90). The prevalence of addictive behaviors was variable (38-59.5%). Tobacco use was the most common addiction (91.7%). More than seventy percent of questioned GPs were regularly consulting patients with known addictive behavior. The diagnosis was incidental in 7% of cases. Sixty percent of patients had predisposing factors for addiction. Diagnostic with screening difficulties for addictive behavior were independently related to doctor’s age >40 (OR = 6.51; p = 0.005), exercise in private clinic (OR= 6.46; p=0.004). Thirty-three percent of GPs were more involved in addiction monitoring. The use of assessment scales was noted in 15%. Young physician age (OR=5.20; p=0.002) and the absence postgraduate diploma in addictology (OR=9.66; p=0.01) were significantly associated addiction management avoidance.ConclusionsThis study aimed to assess of the attitude of GP in Monastir city regarding the addictive behaviors of their patients. The diagnosis and the management of addiction is not standardized for these health practitioners and this will not contribute to the battle against this social entity.Disclosure of InterestNone Declared

To Study the Effect of Individualized Nursing Model Based on MDT Concept on Limb Function Recovery and Quality of Life in Patients with Breast Cancer.

Objective To study the value of the individualized nursing model based on the concept of multidisciplinary team (MDT) on recovery of limb function and quality of life in patients with breast cancer. Methods A total of 110 breast cancer patients admitted to our hospital from January 2021 to December 2021 were selected as the research objects. The 110 breast cancer patients were divided into the research group (n = 55) and the control group (n = 55) according to the random number table method. The control group received routine care. The research group implemented individualized nursing based on the MDT concept on the basis of routine nursing. The disabilities of the arm, shoulder, and hand (DASH) scores before nursing and 1 month after nursing were studied in the two groups, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, and Functional Assessment of Cancer Therapy-B (FACT-B) score. Results After 1 month of nursing, the DASH score of the research group was lower than that of the control group, and the difference was statistically significant (P < 0.05), and after 1 month of nursing, the HAMA score of the research group was lower than that of the control group (P < 0.05). After 1 month of nursing, the HAMD scale score of the research group was lower than that of the control group, and the difference was statistically significant (P < 0.05). After 1 month of nursing, the FACT-B score of the research group was higher than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion The individualized nursing model based on the MDT concept has high application value for breast cancer patients. This nursing model can improve the function of limb movement, relieve the patient's anxiety and depression, and improve the patient's quality of life. This nursing model is worthy of clinical promotion.

The role of multidisciplinary team in breast cancer patients

Breast cancer has become a significant health problem worldwide being one of the most commonly diagnosed malignancies especially due to the wild implementation of screening tests and genetic counselling. Therefore attention was focused on improving the therapeutic strategies in such cases and to offer for each patient the chance of a personalized treatment. In this respect specialized teams have been organized in which each case is discussed and the final decision is transmitted to the patient. That is how the concept of multidisciplinary team developed. The aim of the current paper is to discuss about the concept and benefits of the multidisciplinary meetings in breast cancer patients.

Multi-Disciplinary Team (MDT) Approach in Oral Cancer Management: An Exploratory Study

Background: Treatment of oral cancer has evolved throughout the past decades which has led to the introduction of the multi-disciplinary team approach (MDT). The MDT concept has been endorsed as the main approach to ensure holistic care for oral cancer patients worldwide. In Malaysia, the MDT concept has been introduced in few hospitals throughout the country. According to the available literature, the MDT approach has improved coordination of care for oral cancer patients, communication between the different disciplines, decision making to obtain the best treatment plan, provided educational opportunities for development of the members, and improved staff and patient well-being. However, little evidence is available to support the fact that the MDT approach has improved patient survival and outcome. Aim: The aim of this study was to explore the MDT approach in the management of oral cancer patients. To our knowledge this is the first study on head and neck MDTs in Malaysia. Methods: The study was conducted at University of Malaya. A mixed-method study was commenced including both quantitative and qualitative designs. The quantitative part assessed the MDT members' attitude toward the role and use of the MDT approach in oral cancer patient management, while the qualitative part assessed the perception of the MDT members regarding the MDT approach in terms of: team structure, team process, decision making, barriers and suggestions for improvement of the MDT approach. The quantitative study was conducted through a structured self-administered questionnaire which were both content and face validated, and distributed to the members of the head and neck MDT. The qualitative study was commenced through two focus group discussions (FGDs) conducted separately. Results: The study was conducted among the head and neck MDT members at University Malaya which received a 100% response rate. The majority of the MDT members showed positive attitudes toward the MDT approach, with the seniors being more positive than the juniors. The MDT approach has improved team dynamics in terms of communication, care coordination and decision making. However, there were a few issues of miscommunication as well as long waiting lists for oncological radiotherapy machines and radiologic scanning. Conclusion: The MDT approach is certainly the preferable mode of care for oral cancer patients in University of Malaya. However, there is a need for further improvement with regards to communication between the team members, expansion of the current team composition, training of the MDT members with regards to clinical and nonclinical skills, guidelines, protocols and certain facilities. Teamwork is a fundamental perspective which is crucial for an effective MDT. As such, a better understanding of each other's roles and responsibilities within the team is essential to ensure optimum patient care and management.

Chemical pathologists' role as part of multidisciplinary teams' approach to health-care delivery

Background: The care of the sick has gone beyond a 'one-man show' since the medical profession is dynamic. The dynamism of the profession is to entrench the patients' survival. This is being done by introducing the concept of Multidisciplinary Team (MDT) approach to patients' management. Objective: This review is to have a look at the various roles or ways the Chemical Pathologists can fix into MDT as laboratory physicians. Method: This article discusses the definitions and some terminologies in Chemical Pathology and concept of MDT. Its approach in medicare, went through the historical line and evolution of the subspecialty of Chemical Pathology. It discusses the role of Chemical Pathologists in MDT as well as pros and cons of the concept of MDT. Finally, it also discusses how to improve MDTs in Nigerian Tertiary Hospitals. It was essentially based on literatures written in English. Conclusion: This review article has tried to discuss roles of Chemical Pathologists in MDTs approach to patients' management in our hospitals not leaving out the historical aspects, its advantages, disadvantages, barriers and possible way forward for the suggested challenges.

Multidisciplinary team meetings in urogynaecology

The concept of multidisciplinary team (MDT) is well accepted in the current National Health Service (NHS) and is considered good practice for the management of chronic conditions. There has been a recent drive to have MDTs in managing women with incontinence and complex prolapse as a result of recommendations by National Institute for Health and Care Excellence (NICE) guidance, Medicines and Healthcare Products Regulatory Agency (MHRA) etc. Currently, there are no data on the outcome of case discussion at urogynaecology MDTs. The aim of this study was to review the clinical impact of discussion of a select group of cases at an urogynaecology MDT and review the clinical literature to justify the MDT approach. MDT proformas of cases discussed from October 2012 to December 2013 were reviewed. Outcomes of the MDT were compared with recommendations at the initial consultation. This included change in management plan, type of surgery and surgeon as well as time delay due to MDT discussion. One hundred six proformas were available for analysis. Age range was 23-89 (58) years. Average time from clinic visit to MDT discussion was 8.32 + 5.9 days. The MDT recommended a change in management plan in 31 cases (29.3%), with 11 cases (10.4%) resulting in alternative surgery and 1 case (0.9%) with an alternative surgeon. In 18.5% of cases, MDT discussion formulated the initial management plan. Case discussions at our MDT provide an effective clinical forum to formulate management plans for complex cases. The decision-making process is made robust, without significant impact on waiting time. Investment in setting up MDTs has financial implications but provides patient benefit.

How are symptomatic services run in the United Kingdom?

Breast clinics have developed in a fairly ad hoc way over the past 15 years, often led by experience from breast screening clinics. Although the concept of multidisciplinary teams is now well established, the interaction between members of the teams is much less well defined, particularly as to who is responsible for managing patients through the diagnostic pathway. As part of the Association of Breast Surgery at BASO symptomatic audits that have been carried out over the past 6 years, some units have submitted data on all patients seen in their clinics, giving a dataset of over 100,000 patients from 58 breast units (median age 45, range 1–102). Overall 53% of patients have ultrasound and 57% mammography, with both imaging methods used in 32%. Needle biopsies (core or fine needle aspiration cytology) are carried out on 26% of patients, with 69% showing benign pathology. The pre-operative cancer diagnosis rate is 91%. This dataset has been explored to look at variation in practice across units, and shows quite wide variation in the reported use of mammo-graphy (26–100%), ultrasound (4–96%), and needle biopsy (6–57%), although this does not obviously alter the cancer diagnosis rates for individual units. These results will be presented to inform discussion on what may be best practice.

Multidisciplinary Teams and Group Decision-Making Techniques: Possible Solutions to Decision-Making Problems

Although the concept of multidisciplinary team (MDT) decision-making holds a degree of face validity, empirical investigations indicate the MDTs are not as facilitative, perhaps, as we would like t...