Skip to main content

Advertisement

SpringerLink
Log in

Evidence for the urogynaecology multidisciplinary team meeting: evaluation from a secondary care perspective

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction

Urogynaecology multidisciplinary team (MDT) meetings to discuss management plans prior to invasive treatments for urinary incontinence have been recommended by guidelines in the UK since 2013. Evidence for MDT discussion in urogynaecology is lacking, with only two published studies. The aim of this study was to evaluate the cases discussed at a secondary care urogynaecology MDT meeting, to establish types of clinical problems discussed, assess the outcomes of the MDT meeting and compare this with existing evidence for MDT meetings in urogynaecology.

Methods

A retrospective review of meeting minutes and all case notes for patients discussed at 12 MDT meetings over 13 months was carried out. Data collected included attendance from different staff groups, reasons for referral, outcome of discussions, and changes to management plans.

Results

A total of 123 cases were discussed over 12 meetings, 7 members of staff attended each meeting on average. 63% of cases were referred for discussion of a primary problem. The majority of patients were referred for discussion of management of urinary incontinence prior to invasive procedures (57%). The agreed MDT plan corresponded with proposed management in 67% of cases, with changes to management plan in 31% of cases.

Conclusion

Refinements to management plans in this study highlight the importance of MDT input in urogynaecology care and mirror the findings of two previous studies. Evidence for improved outcomes and the cost-effectiveness of MDTs is lacking and is an area for future research. Expanded national guidance for urogynaecology MDTs is likely to require local and regional restructuring of these in the UK.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Expert Advisory Group on Cancer. A policy framework for commissioning cancer services: a report to the chief medical officer of England and Wales. The Calman–Hine Report. London: Department of Health; 1995.

    Google Scholar 

  2. Munro A, Brown M, Niblock P, Steele R, Carey F. Do multidisciplinary team (MDT) processes influence survival in patients with colorectal cancer? A population-based experience. BMC Cancer. 2015;15:686.

    Article  Google Scholar 

  3. MacDermid E, Hooton G, MacDonald M, McKay G, Grose D, Mohammed N, et al. Improving patient survival with the colorectal cancer multi-disciplinary team. Colorectal Dis. 2009;11(3):291–29.

    Article  CAS  Google Scholar 

  4. Bydder S, Nowak A, Marion K, Phillips M, Atun R. The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer. Intern Med J. 2009;12:838–41.

    Article  Google Scholar 

  5. Pan CC, Kung PT, Wang YH, Chang YC, Wang ST, Tsai WC. Effects of multidisciplinary team care on the survival of patients with different stages of non-small cell lung cancer: a national cohort study. PLoS One. 2015;10(5):e0126547. https://doi.org/10.1371/journal.pone.0126547.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Kesson EM, Allardice GM, George WD, Burns HJG, Morrison DS. Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ. 2012;344:e2718.

    Article  Google Scholar 

  7. Hong NJ, Wright FC, Gagliardi AR, Paszat LF. Examining the potential relationship between multidisciplinary cancer care and patient survival: an international literature review. J Surg Oncol. 2010;102(2):125–34.

    Article  Google Scholar 

  8. Pillay B, Wooten AC, Crowe H, Corcoran N, Tran B, Bowden P, et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: a systematic review of the literature. Cancer Treat Rev. 2016;42:56–72.

    Article  Google Scholar 

  9. Wright A, Helm J, Spencer L, Leonard C, Bishop P, Greaves M, et al. S12 interstitial lung disease multidisciplinary discussion: six years of data from a tertiary service. Thorax. 2013;68:A9–A10.

    Article  Google Scholar 

  10. Morar P, Read J, Arora S, Hart A, Warusavitarne J, Green J, et al. Defining the optimal design of the inflammatory bowel disease multidisciplinary team: results from a multicentre qualitative expert-based study. Frontline Gastroenterol 2015;6:290–7.

    Article  Google Scholar 

  11. Ghosh S. Multidisciplinary teams as standard of care in inflammatory bowel disease. Can J Gastroenterol. 2013;27(4):198. https://doi.org/10.1155/2013/710671.

    Article  PubMed  PubMed Central  Google Scholar 

  12. National Institute for Health and Care Excellence. Crohn’s disease: management (CG152), 2012. Available at: https://www.nice.org.uk/guidance/cg152. Accessed 26 July 2019.

  13. National Institute for Health and Care Excellence. Ulcerative colitis: management (CG166), 2013. Available at https://www.nice.org.uk/Guidance/CG166. Accessed 26 July 2019.

  14. Adorian D, Silverberg DS, Tomer D, Wasmosher Z. Group discussions with the health care team – a method of improving care of hypertension in general practice. J Hum Hypertens. 1990;4(3):265–8.

    CAS  PubMed  Google Scholar 

  15. Sim TA, Joyner J. A multidisciplinary team approach to reducing medication variance. Jt Comm J Qual Improv. 2002;28(7):403–9.

    PubMed  Google Scholar 

  16. Caplan GA, Williams AJ, Daly B, Abraham K. A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly patients in an emergency department—the DEED II study. J Am Geriatr Soc. 2004;52(9):1417–23.

    Article  Google Scholar 

  17. McAlister FA, Stewart S, Ferrua S, McMurray JJJV. Multidisciplinary strategies for the management of heart failure patients at high risk for admission. J Am Coll Cardiol. 2004;44(4):810–9.

    PubMed  Google Scholar 

  18. Firdaus M, Elzubier M, Majumdar D, Greenaway J. Role of MDT in management of benign HPB disease-experience from a non-HPB centre in UK. Gut. 2018;67:A236–7.

    Google Scholar 

  19. National Institute for Health and Care Excellence. Urinary incontinence in women: management. NICE Guideline (CG171), 2013. Available at: https://www.nice.org.uk/guidance/cg171. Accessed 26 July 2019.

  20. National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management NG23, 2019. Available at: https://www.nice.org.uk/guidance/ng123/resources/urinary-incontinence-and-pelvic-organ-prolapse-in-women-management-pdf-66141657205189. Accessed 26 July 2019.

  21. Gopinath D, Jha S. Multidisciplinary team meetings in urogynaecology. Int Urogynecol J. 2015;26(8):1221–7. https://doi.org/10.1007/s00192-015-2662-4.

    Article  PubMed  Google Scholar 

  22. Balachandran A, Duckett J. What is the role of the multidisciplinary team in the management of urinary incontinence? Int Urogynecol J. 2015;26(6):791–3. https://doi.org/10.1007/s00192-014-2579-3.

    Article  PubMed  Google Scholar 

  23. Pandeva I, Biers S, Pradhan A, Verma V, Slack M, Thiruchelvam N. The impact of pelvic floor multidisciplinary team on patient management: the experience of a tertiary unit. J Multidiscip Healthc. 2019;12:205–10.

    Article  Google Scholar 

  24. Jha S, Cutner A, Moran P. The UK national prolapse survey: 10 years on. Int Urogynecol J. 2018;29(6):795–801.

    Article  Google Scholar 

  25. Lamb BW, Brown KF, Nagpal K, Vincent C, Green JSA, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18:2116.

    Article  Google Scholar 

  26. Balachandran A, Monga A, Duckett J. Management of female urinary incontinence: a survey of urogynaecologists’ view on the NICE guideline. J Obstet Gynaecol. 2016;36(4):487–91.

    Article  CAS  Google Scholar 

  27. Raine R, Wallace I, Nic A, Bháird C, Xanthopoulou P, Lanceley A, et al. Improving the effectiveness of multidisciplinary team meetings for patients with chronic diseases: a prospective observational study. Southampton, UK: NIHR Journals Library; 2014.

    Google Scholar 

  28. Ke MK, Blazeby JM, Strong S, Carroll FE, Ness AR, Hollingworth W. Are multidisciplinary teams in secondary care cost effective? A systematic review of the literature. Cost Eff Resour Alloc. 2013;11:7.

    Article  Google Scholar 

Download references

Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Sheffield Teaching Hospitals NHS Foundation Trust, c/o Tricia Kenyon, Level 4, Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, UK

    Keren E. Wales & Thomas G. Gray

  2. The Rotherham Foundation NHS Trust, Rotherham, UK

    Keren E. Wales & Anupama Saxena

Authors
  1. Keren E. Wales
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anupama Saxena
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas G. Gray
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas G. Gray.

Ethics declarations

Conflicts of interest

All authors (K. Wales, A. Saxena and T. Grey) declare that they have no financial disclaimers or conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wales, K.E., Saxena, A. & Gray, T.G. Evidence for the urogynaecology multidisciplinary team meeting: evaluation from a secondary care perspective. Int Urogynecol J 31, 1181–1189 (2020). https://doi.org/10.1007/s00192-019-04154-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-019-04154-x

Keywords

Search

Navigation