open access publication

Article, 2024

Network of doctors for multimorbidity and diabetes — the NOMAD intervention: protocol for feasibility trial of multidisciplinary team conferences for people with diabetes and multimorbidity

Pilot and Feasibility Studies, ISSN 2055-5784, Volume 10, 1, Page 91, 10.1186/s40814-024-01517-0

Contributors

Bugge, Stine Jorstad 0000-0002-8618-2938 (Corresponding author) [1] [2] Henriksen, Daniel Pilsgaard 0000-0003-1303-6195 [1] [2] Damkier, Per 0000-0003-0591-7187 [1] [2] Rahbek, Martin Torp 0000-0001-7506-3426 [1] [2] Schousboe, Karoline 0000-0003-3824-7482 [1] [2] Rothmann, Mette Juel 0000-0001-6505-4163 [1] [2] Poulsen, Marianne Kjær [1] [2] Hansen, Camilla [1] Nagarajah, Subagini 0000-0001-8855-2448 [1] [2] Jensen, Per Bruno [1] [2] Johansson, Sofie Lock 0000-0003-0597-9468 [1] [2] Panou, Vasiliki 0000-0002-3607-5640 [1] [2] Schneider, Ida Ransby [1] [2] Pedersen, Charlotte Gjørup 0000-0003-1116-8389 [3] [4] Andersen, Jonas Dahl 0000-0001-6619-9161 [5] [6] Hangaard, Jo Rgen [1] [2] Zwisler, Ann-Dorthe Olsen 0000-0002-9241-2090 [1] [2]

Affiliations

  1. [1] Odense University Hospital
    2. [NORA names: Region of Southern Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  2. [2] University of Southern Denmark
    3. [NORA names: SDU University of Southern Denmark; University; Denmark; Europe, EU; Nordic; OECD];
  3. [3] Aarhus University
    4. [NORA names: AU Aarhus University; University; Denmark; Europe, EU; Nordic; OECD];
  4. [4] Aarhus University Hospital
    5. [NORA names: Central Denmark Region; Hospital; Denmark; Europe, EU; Nordic; OECD];
  5. [5] Aalborg University
    6. [NORA names: AAU Aalborg University; University; Denmark; Europe, EU; Nordic; OECD];

Abstract

BackgroundThe prevalence of diabetes and coexisting multimorbidity rises worldwide. Treatment of this patient group can be complex. Providing an evidence-based, coherent, and patient-centred treatment of patients with multimorbidity poses a challenge in healthcare systems, which are typically designed to deliver disease-specific care. We propose an intervention comprising multidisciplinary team conferences (MDTs) to address this issue. The MDT consists of medical specialists in five different specialities meeting to discuss multimorbid diabetes patients. This protocol describes a feasibility test of MDTs designed to coordinate care and improve quality of life for people with diabetes and multimorbidity.MethodsA mixed-methods one-arm feasibility test of the MDT. Feasibility will be assessed through prospectively collected data. We will explore patient perspectives through patient-reported outcomes (PROs) and assess the feasibility of electronic questionnaires. Feasibility outcomes are recruitment, PRO completion, technical difficulties, impact of MDT, and doctor preparation time. During 17 months, up to 112 participants will be recruited. We will report results narratively and by the use of descriptive statistics. The collected data will form the basis for a future large-scale randomised trial.DiscussionA multidisciplinary approach focusing on better management of diabetic patients suffering from multimorbidity may improve functional status, quality of life, and health outcomes. Multimorbidity and diabetes are highly prevalent in our healthcare system, but we lack a solid evidence-based approach to patient-centred care for these patients. This study represents the initial steps towards building such evidence. The concept can be efficiency tested in a randomised setting, if found feasible to intervention providers and receivers. If not, we will have gained experience on how to manage diabetes and multimorbidity as well as organisational aspects, which together may generate hypotheses for research on how to handle multimorbidity in the future.Administrative informationProtocol version: 01Trial registrationNCT05913726 — registration date: 21 June 2023

Keywords

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Funders

  • Novo Nordisk Foundation

Data Provider: Digital Science

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