Clinical and economic outcomes of multidisciplinary team members in primary care: a scoping review

Abstract

Abstract Background Multidisciplinary teams are gaining popularity as an operational model in primary care. Evidence about their clinical results and costs is unclear. Likewise, it remains unknown which professionals should be present in the teams. We aimed to investigate which disciplines have been added to primary care teams, what are the target populations, and what is known about their impact on clinical results and costs. Methods This scoping review is based on literature searches in OVID Medline, Scopus and CINAHL. The search terms “primary care”, “multidisciplinary team”, “intervention” and “outcome” and their synonyms were used to identify the potential body of literature from research published between January 2013 and March 2024. The review process followed the PRISMA Scoping Review guidelines and a critical appraisal of studies with both clinical and cost outcomes was accomplished using JBI check lists. Results The literature search identified 2981 articles for screening, 46 of which satisfied all inclusion/exclusion criteria. 26 studies focused exclusively on pharmacists and nine studies had a mix of competencies in addition to a pharmacist while the remaining 11 studies explored various other professional groups. Most interventions targeted patients with cardiovascular diseases and/or multimorbidity (n = 26) while five studies addressed the prevention of hospitalizations and five targeted polypharmacy. Positive impacts on clinical outcomes were observed in 34 studies, two studies declared mixed effect, five studies reported the intervention to have no dominance over usual care, and five studies lacked evidence in either way. Five out of eight studies exploring cost outcomes had positive impacts while three studies lacked evidence to declare impact. Conclusions There is most evidence on adding pharmacists to a team of primary care doctors and nurses when targeting cardiovascular, polypharmaceutical, and patients with multimorbid, chronic diseases. Evidence on positive clinical impact is most convincing, but cost savings were also projected. There is a research gap considering other professionals’ impact on clinical outcomes and costs. Comparative, long-term research on the field is needed.

Keywords

• Quadruple aim
• Multidisciplinary team
• Primary care
• Cost outcomes
• Clinical outcomes