Heart transplant centers with multidisciplinary team show a higher level of chronic illness management - Findings from the International BRIGHT Study
Maan Isabella Cajita, Eva Baumgartner, Lut Berben, Kris Denhaerynck, Remon Helmy, Sandra Schönfeld, Gabriele Berger, Christine Vetter, Fabienne Dobbels, Cynthia L Russell, Sabina De Geest, BRIGHT Study Team, Maria G Crespo-Leiro, Sandra Cupples, Paolo De Simone, Albert Groenewoud, Christiane Kugler, Linda Ohler, Johan Van Cleemput, Alain Jean Poncelet, Laurent Sebbag, Magali Michel, Andrée Bernard, Andreas Doesch, Ugolino Livi, Valentina Manfredini, Vicens Brossa-Loidi, Javier Segovia-Cubero, Luis Almenar-Bonet, Carmen Segura Saint-Gerons, Paul Mohacsi, Eva Horvath, Cheryl Riotto, Gareth Parry, Ashi Firouzi, Stella Kozuszko, Haissam Haddad, Annemarie Kaan, Grant Fisher, Tara Miller, Maureen Flattery, Kristin Ludrosky, Bernice Coleman, Jacqueline Trammell, Katherine St Clair, Andrew Kao, Maria Molina, Karyn Ryan Canales, Samira Scalso de Almeida, Andrea Cotait Ayoub, Fernanda Barone, Michelle Harkess, Joanne Maddicks-Law, Maan Isabella Cajita, Eva Baumgartner, Lut Berben, Kris Denhaerynck, Remon Helmy, Sandra Schönfeld, Gabriele Berger, Christine Vetter, Fabienne Dobbels, Cynthia L Russell, Sabina De Geest, BRIGHT Study Team, Maria G Crespo-Leiro, Sandra Cupples, Paolo De Simone, Albert Groenewoud, Christiane Kugler, Linda Ohler, Johan Van Cleemput, Alain Jean Poncelet, Laurent Sebbag, Magali Michel, Andrée Bernard, Andreas Doesch, Ugolino Livi, Valentina Manfredini, Vicens Brossa-Loidi, Javier Segovia-Cubero, Luis Almenar-Bonet, Carmen Segura Saint-Gerons, Paul Mohacsi, Eva Horvath, Cheryl Riotto, Gareth Parry, Ashi Firouzi, Stella Kozuszko, Haissam Haddad, Annemarie Kaan, Grant Fisher, Tara Miller, Maureen Flattery, Kristin Ludrosky, Bernice Coleman, Jacqueline Trammell, Katherine St Clair, Andrew Kao, Maria Molina, Karyn Ryan Canales, Samira Scalso de Almeida, Andrea Cotait Ayoub, Fernanda Barone, Michelle Harkess, Joanne Maddicks-Law
Abstract
Objectives: The objectives of this study were to: (1) explore the proportion of HTx centers that have a multidisciplinary team and (2) assess the relationship between multidisciplinarity and the level of chronic illness management (CIM).
Background: The International Society for Heart and Lung Transplantation (ISHLT) recommends a multidisciplinary approach in heart transplant (HTx) follow-up care but little is known regarding the proportion of HTx centers that meet this recommendation and the impact on patient care. HTx centers with a multidisciplinary team may offer higher levels of CIM, a care model that has the potential to improve outcomes after HTx.
Methods: We conducted a secondary analysis of the BRIGHT study, a cross-sectional study in 11 countries. Multidisciplinarity in the 36 HTx centers was assessed through HTx director reports and was defined as having a team that was composed of physician(s), nurse(s), and another healthcare professional (either a social worker, psychiatrist, psychologist, pharmacist, dietician, physical therapist, or occupational therapist). CIM was assessed with the Patient Assessment of Chronic Illness Care (PACIC). Multiple linear regression assessed the relationship between multidisciplinarity and the level of CIM.
Results: Twenty-nine (80.6%) of the HTx centers had a multidisciplinary team. Furthermore, multidisciplinarity was significantly associated with higher levels of CIM (β = 5.2, P = 0.042).
Conclusion: Majority of the HTx centers follows the ISHLT recommendation for a multidisciplinary approach. Multidisciplinarity was associated with CIM and point toward a structural factor that needs to be in place for moving toward CIM.
Keywords: Chronic illness management; Heart transplantation; Multidisciplinary teams.
Copyright © 2017 Elsevier Inc. All rights reserved.
Source: PubMed