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Results for “multidisciplinary”

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At least 19 recordsLinked to original sources

PubMed2026

Multidisciplinary mHealth Rehabilitation for Patients With Abdominal Cancer Who Are Receiving Chemoradiotherapy: Randomized Phase II Trial.

BACKGROUND: Concurrent chemoradiotherapy (CCRT) for abdominal cancer frequently induces muscle loss, weight loss, and malnutrition. OBJECTIVE: This exploratory randomized phase II trial evaluated whether a multidisciplinary, mobile health (mHealth)-based multimodal rehabilitation program could preserve handgrip strength and muscle mass in patients with abdominal cancer undergoing CCRT. METHODS: In this prospective, multicenter, randomized, open-label phase II trial (NCT05325554), 111 eligible patients with abdominal malignancies scheduled for CCRT were randomly assigned (1:1) to receive either multidisciplinary mHealth rehabilitation care (MRC; n=57) or standard care (SC; n=54). The MRC program was delivered by a dedicated multidisciplinary team using the AiNST mHealth platform and wearable heart rate monitors. The primary end point was handgrip strength at the end of CCRT (analyzed with analysis of covariance adjusting for baseline). Secondary end points were exploratory and analyzed without multiplicity adjustment; sensitivity analysis using false discovery rate (FDR) correction was performed. RESULTS: Between February 2022 and April 2023, 111 patients were enrolled. Adherence was high (n=93, 83.9% achieved exercise targets). After adjusting for baseline handgrip strength, the MRC group had significantly higher handgrip strength at the end of CCRT than the SC group (adjusted mean difference 4.87 kg, 95% CI 3.36-6.38; P<.001). Exploratory analyses of secondary end points (without multiplicity adjustment) showed that the MRC group also had better preservation of body weight (P=.005), skeletal muscle mass (P<.001), serum albumin (P=.009), prealbumin (P=.02), and lower rates of hematological toxicity (P<.05), as well as improved psychological status (distress thermometer [DT] and Hospital Anxiety and Depression Scale [HADS]) and nutritional scores (Nutritional Risk Screening 2002 [NRS-2002] and Patient-Generated Subjective Global Assessment [PG-SGA]) at the end of CCRT (all P<.05). All nominally significant secondary end points remained significant after FDR correction (q<.05). These findings are preliminary and should be interpreted with caution due to the open-label design, population heterogeneity, and exploratory secondary analyses. CONCLUSIONS: In this exploratory phase II trial, a multidisciplinary, mHealth-based multimodal rehabilitation program was associated with better preservation of handgrip strength, muscle mass, and nutritional status, as well as lower rates of certain treatment toxicities, compared with SC. However, definitive conclusions are limited by the open-label design, heterogeneity of tumor types, and short follow-up. Larger, blinded phase III trials are needed to confirm these findings.

Humans↗

PubMed1992

Efficacy of multidisciplinary pain treatment centers: a meta-analytic review.

Sixty-five studies that evaluated the efficacy of multidisciplinary treatments for chronic back pain were included in a meta-analysis. Within- and between-group effect sizes revealed that multidisciplinary treatments for chronic pain are superior to no treatment, waiting list, as well as single-discipline treatments such as medical treatment or physical therapy. Moreover, the effects appeared to be stable over time. The beneficial effects of multidisciplinary treatment were not limited to improvements in pain, mood and interference but also extended to behavioral variables such as return to work or use of the health care system. These results tend to support the efficacy of multidisciplinary pain treatment; however, these results must be interpreted cautiously as the quality of the study designs and study descriptions is marginal. Suggestions for improvement in research designs as well as appropriate reports of research completed are provided.

Adult↗

PubMed1991

Comprehensive multidisciplinary treatment of chronic pain: a follow-up study of treated and non-treated groups.

There are relatively few outcome studies of multidisciplinary chronic pain programs which have utilized no-treatment comparison groups. The present study compared a group of chronic pain patients (N = 42) treated in a comprehensive multidisciplinary pain program with a group of patients (N = 15) who were evaluated but not treated. Comparisons were made at evaluation and at a follow-up period averaging 11 months later. From evaluation to discharge, the treated group showed significant increases in physical functioning. From evaluation to long-term follow-up, both the treated and non-treated groups showed significant decreases in self-report pain ratings and interference with activities ratings. However, only the treated group showed a significant decrease in addictive medication use and increase in work functioning. The return-to-work rate for the treated group was 48% with an additional 28% of the patients being returned to vocational rehabilitation. None of the non-treated group returned to work or vocational rehabilitation. Results are discussed in terms of their support for the conclusion that comprehensive multidisciplinary pain programs produce marked subjective and functional changes.

Adult↗

PubMed1976

Psychiatric training for emergency medicine residents on a multidisciplinary team.

The Cincinnati General Hospital Emergency Department has a training program for emergency medicine residents on a multidisciplinary emergency psychiatry team. This essential training should occur in the emergency department setting rather than in psychiatric inpatient units of state hospital settings. There are advantages and disadvantages to this arrangement. Nonmedical members of the emergency psychiatry team train and support emergency medicine residents in a multidisciplinary approach to treatment. Some observations are made about how the emergency medicine residents deal with emotionally disturbed patients. Finally, 80% of emergency medicine residents responded to questionnaire on their reactions to the multidisciplinary emergency psychiatry team.

Attitude of Health Personnel↗

PubMed1979

A multidisciplinary clerkship in emergency medicine.

An obligatory, multidisciplinary, fourth-year emergency medicine clerkship is described and the particular problems of multidisciplinary courses discussed. The course is designed to produce medical students who adequately demonstrate: knowledge of emergency care and facility in specified skills, familiarity with the appropriate use of an emergency room, and conversance with treatment of nonemergency cases. Students are required to complete successfully an advanced cardiac life support providers course, serve on ambulance duty, rotate through a community hospital emergency room, and participate in the more traditional clinical experiences. The course offers the fourth-year student an opportunity to synthesize prior knowledge within the context of a multidisciplinary patient care experience.

Clinical Competence↗

PubMed1975

Home bases for private work and study. Are multidisciplinary laboratories the best answer?

Since 1970 we have measured the use of our multidisciplinary laboratories as home study bases for out-of-hours private work, and find that our students make little use of them in this way, preferring to work in study-bedrooms or libraries. We consider that there is no need to incorporate private study areas in the design of multidisciplinary laboratories, with the result that uncluttered areas with free sight lines can be used for a variety of purposes; we suggest that multidisciplinary laboratories will evolve in the future along this multi-purpose, multifunction line.

Curriculum↗

PubMed1977

Multidisciplinary collaboration in fieldwork: Australian studies.

The Australian situation offers special insights for cross-cultural psychiatric research. The two cultures that "crossed" in Australia were diametrically opposed in their characteristics. Suffering, which is considered to be the raison d'être of cross-cultural psychiatry, became pandemic among Aborigines, not only because the invading society was ruthlessly aggressive, but also because the invaded society did not have the social institutions and modal personality patterns enabling it to adapt to the introduced culture. It is suggested that no applied science makes more demands of more scientific disciplines than does cross-cultural psychiatry. Psychiatry itself is a multidisciplinary science. The amount of information needed by the cross-cultural extension of psychiatry is further expanded. Only a multidisciplinary approach can furnish the necessary level of information. An outline is given of multidisciplinary field work in Australia, indicating advantages and difficulties inherent in it. Attention is drawn to literature in which details of the results may be found. The Australian work leads to the conclusion that if the relief of suffering is the aim then greater involvement is needed in cross-cultural psychiatry from the culture that has been "crossed".

Australia↗

PubMed1991

The effect of a multidisciplinary team approach on weight gain in nonorganic failure-to-thrive children.

Failure-to-thrive (FTT) is a chronic symptom accounting for 1% of all patients admitted to pediatric hospitals. FTT, which is traditionally attributed to organic (OFTT) and/or nonorganic (NFTT) causes, results in undernutrition. Undernutrition has potentially serious effects on child development, behavior, and cognitive skills. We undertook a study of children with FTT to determine whether multidisciplinary team treatment resulted in improved weight gain compared with children treated in a primary care setting. Fifty-three children with NFTT referred to our outpatient FTT consultative clinic and 107 children with NFTT identified as comparison subjects from our primary care clinic (PCC) were enrolled in the study. Growth outcomes over a 6-month follow-up were analyzed using growth quotient (GQ) analysis. Children followed in the multidisciplinary team clinic grew better (GQ = 1.75 +/- 0.39 SD) than did children in the PCC (GQ = 1.18 +/- 0.42 SD, p less than .001). The use of a multidisciplinary team offers special advantages in the rapid correction of undernutrition in children with NFTT.

Child, Preschool↗

PubMed2024

Genomics-informed neuropsychiatric care for neurodevelopmental disorders: Results from a multidisciplinary clinic.

PURPOSE: Patients with neurodevelopmental disorders (NDDs) have high rates of neuropsychiatric comorbidities. Genomic medicine may help guide care because pathogenic variants are identified in up to 50% of patients with NDDs. We evaluate the impact of a genomics-informed, multidisciplinary, neuropsychiatric specialty clinic on the diagnosis and management of patients with NDDs. METHODS: We performed a retrospective study of 316 patients from the University of California, Los Angeles Care and Research in Neurogenetics Clinic, a genomics-informed multidisciplinary clinic. RESULTS: Among the 246 patients who underwent genetic testing, 41.8% had a pathogenic or likely pathogenic variant. Patients had 62 different genetic diagnoses, with 12 diagnoses shared by 2 or more patients, whereas 50 diagnoses were found in only single patients. Genetic diagnosis resulted in direct changes to clinical management in all patients with a pathogenic or likely pathogenic variant, including cascade testing (30.6%), family counseling (22.2%), medication changes (13.9%), clinical trial referral (2.8%), medical surveillance (30.6%), and specialty referrals (69.4%). CONCLUSIONS: A genomics-informed model can provide significant clinical benefits to patients with NDDs, directly affecting management across multiple domains for most diagnosed patients. As precision treatments advance, establishing a genetic diagnosis will be critical for proper management. With the growing number of rare neurogenetic disorders, clinician training should emphasize core principles of genomic medicine over individual syndromes.

Humans↗

PubMed1991

Intraoperative radiotherapy in the multidisciplinary treatment of bone sarcomas in children and adolescents.

From September 1984 to December 1989, 38 patients of pediatric age with localized bone sarcomas received intraoperative radiotherapy (IORT) as part of a multidisciplinary treatment program. The age ranged from 6 to 21 years. The tumor histologies were 22 osteosarcomas and 16 Ewing's sarcomas. Thirty-four had initial primary disease (90%) and 4 were treated for local recurrence (10%). IORT was used on 32 untreated patients and in 6 previously treated with external beam radiotherapy (EBR). The IORT field included the surgically exposed tumor bed area. Single radiation doses ranging from 10 to 20 Gy were delivered, using 6-20 MeV electron beams. The median follow-up time for the entire group is 25 months (2-65+ months). The projected 5-year disease-free and overall survival rates are 65% and 69%, respectively. One patient developed a local recurrence in each histological group: one chondroblastic osteosarcoma and one cervical Ewing's sarcoma. Six patients died from metastatic progression: 3 initially recurrent tumors and three primary disease cases. Severe neuropathy and soft tissue necrosis were seen in some patients as IORT related complications. IORT is a feasible technique to be integrated in multidisciplinary programs that may promote local control in pediatric and adolescent patients with bone sarcomas. Peripheral nerves are dose-limiting tissue structures for IORT.

Adolescent↗

PubMed1978

Multidisciplinary treatment of chronic pain: long-term follow-up of low-back pain patients.

Thirty-six patients with low-back pain who had been treated in our multidisciplinary pain center returned for 80-week follow-up evaluations by the staff pscyhologist, physiatrist and physical therapist. Statistically significant gains were maintained in the reduction of prescription analgesics and on 4 measures of physical functioning: (a) long-sittimg-to-toe; (b) straight-leg-raise; (c) knee-to-chest; and (d) overall exercise performance. Despite verbal reports of continuing pain, most patients claimed they were coping much better with it, and they displayed a marked reduction in their utilization of medical resources for further pain treatment. These long-term results suggest that a multidisciplinary approach can offer an effective means of treating chronic low-back pain.

Adaptation, Psychological↗

PubMed2026

Management of complex lipid disorders in a community lipid clinic setting: Implementing a multidisciplinary model.

BACKGROUND: Large treatment gaps exist in the management of lipid disorders, and many high-risk patients have factors that complicate management efforts. While lipid clinics exist within academic medical centers, most of these patients are cared for in community settings. OBJECTIVE: To report our experience and results managing challenging and complex lipid disorders in a community-based lipid clinic. METHODS: We established a specialized lipid clinic in a community medical setting, with a focus on patients with management challenges and/or suspicion of a genetic lipid disorder, employing a multidisciplinary approach to optimize patient outcomes, emphasizing appropriate medical therapies and lipid genetic testing in selected patients. Retrospective electronic health record data were collected to analyze patient characteristics, treatment patterns, and lipid results. RESULTS: Over the period 2022 through 2024, 183 patients were seen (mean 63 years, 62% female). The challenging nature of the patient population was highlighted by high rates of statin intolerance (50%), no lipid medical therapy at baseline (50%), and comorbidities (atherosclerotic cardiovascular disease [ASCVD], diabetes, and/or hypertension-61%). Despite this, over a mean follow-up of 9.4 ± 7.3 months, we observed a mean low-density lipoprotein cholesterol decrease of 49 mg/dL (-24.5%, P < .001), along with significant decreases in total cholesterol and triglycerides. Pathogenic dyslipidemia genetic variants were discovered in 21 patients (of 105 tested). Significant lipid improvements in the whole cohort, as well as multiple subgroups, were associated with greater utilization of combination therapies. CONCLUSION: Patients with complex lipid disorders can be successfully managed within a specialized lipid clinic in community medical settings. Applying such a multidisciplinary model outside of traditional academic medical centers offers the potential to raise the level of lipid management and ASCVD prevention more broadly in larger populations.

Combination medical therapy↗

PubMed1991

Multidisciplinary treatment of chronic craniomandibular disorder: a preliminary investigation.

Historically, chronic pain patients have been treated utilizing an acute care model with little success. The present study examined the effectiveness of using a multidisciplinary team approach for chronic pain patients diagnosed with craniomandibular disorders. Preliminary findings showed that patients made significant functional improvements across both physical and psychological measures, despite the persistence of reported pain at the time of follow-up evaluation. These results demonstrate the relative benefits associated with the treatment of chronic craniomandibular disorder patients in a multidisciplinary pain facility.

Adult↗

PubMed1992

Multidisciplinary approaches to management of acute head injury.

The formation of a multidisciplinary head injury team at St. Michael's Hospital has served to improve the quality of care for acutely head-injured patients. The multidisciplinary team follows the patient from the neurosurgical intensive care unit to the early rehabilitation phase. Treatment for the patient and family focuses on physical, cognitive and psychosocial areas. Cooperation of the various medical and paramedical professionals facilitates earlier and more comprehensive treatment for patients and their families, while enhancing research.

Communication↗

PubMed1977

Verbal communication between students in multidisciplinary health teams.

The study reported here was connected with the influence of two variables--the context in which communication occurs, and the concept availability of various health professionals--upon the verbal interaction of various health professionals. Specifically, the verbal output of health professionals in groups consisting entirely of their own professional peers (i.e. all nurses, or all medical students) was compared with that of professionals in multidisciplinary health teams. The study, in attempting to delineate possible barriers to effective verbal interaction, has important implications for the functioning of multidisciplinary health teams.

Australia↗

PubMed1978

Multidisciplinary training in family planning.

A review of 3 years' experience with multidisciplinary training in Family Planning involving representatives from nursing, medical, social work and education professions is presented. The multidisciplinary principle has been shown to be of value in this field, particularly in respect of improved communication.

Curriculum↗

PubMed1976

Multidisciplinary treatment for macrometastatic osteogenic sarcoma.

Using a co-ordinated multidisciplinary approach with surgery, radiation therapy, and chemotherapy, 14 out of 21 patients with metastases from osteogenic sarcoma were rendered free of disease for over two to over 18 months. Most patients had pulmonary metastases, two had bony metastases, and one had metastases in the iliac nodes. As part of this multidisciplinary approach weekly high-dose methotrexate was given and caused tumour regression in seven out of 15 patients. After all clinical evidence of disease had been removed high-dose methotrexate was administered every two to three weeks as maintenance treatment. To assess the efficacy of treatment the results were compared with those in a historical control group of 82 consecutive patients who developed pulmonary or other metastases. The results in the study group were significantly better. This experience may be similar to that in Wilms's tumour, where actinomycin D has increased the cure rate when administered as adjuvant therapy after treatment of localised or overt metastatic disease.

Adolescent↗

PubMedDate not supplied

A multidisciplinary, comprehensive, ambulatory treatment scheme for diabetes mellitus in children.

A study has been carried out on 262 children with juvenile diabetes and their parents, treated up to 10 yr on an ambulatory basis by a multidisciplinary team composed of pediatric endocrinologist, nurse, dietitian, psychologist, and social worker. Comparison of the findings with those of a study performed before inception of the Counselling Center for Juvenile Diabetics revealed the following positive influences: the degree of control attained was both higher and sustained with greater regularity; there were fewer complications with no episodes of coma, brittle diabetes, or severe ketoacidosis and almost no need for hospitalization; the attitude of the affected child, his parents, and his teachers was found to be considerably improved; there was better understanding of the nature of the disease and its requirements; the child's motivation to maintain the diabetic regimen was greater and conflicts within the family circle were markedly reduced; the child's self-concept was much higher; and both scholastic achievements and social adjustment were greater. We concluded that psychological stability is a basic factor in the control of diabetes, and the value of the multidisciplinary approach in the treatment of this chronic disease is indicated.

Ambulatory Care↗