Patient outcomes and clinical practice for spondyloarthritis-inflammatory bowel disease (SpA-IBD) can be significantly improved through regular multidisciplinary team (MDT) meetings, researchers report.
A UK single centre analysis has shown the positive impact such meetings can have, as patients, doctors and the institution “all greatly benefited to a great extent”.
The findings also support use of MDTs in other areas of rheumatology and gastroenterology, according to the paper, published in Rheumatology (link here).
The retrospective, observational, case-note review looked at outcomes for 226 cases discussed at SpA-IBD MDT meetings, which were held every two months.
Patients referred to the MDT either had an established diagnosis of SpA and/or IBD, with one or both uncontrolled by treatment, or clinical symptoms indicating the presence of either condition.
Analysis of the data showed that in more than half of cases (57%), MDT discussion drove an “instant change” in disease management, such as change or reduction in immunomodulatory therapy.
In 9% of cases, patients were prescribed medicines that at that point were only licensed for use in one specialty but in late stage clinical development for the other, “thereby improving treatment options available in the management of complex cases”, the authors noted.
Notably, MDT discussions “improved patient safety by avoiding the accidental prescription of two different advanced immunomodulators,” and also “led to the establishment of a more refined biologic prescribing policy, enabling a few of the most complex patients to receive dual biologic therapy,” they said.
Crucially, MDT meetings were also “highly cost and time efficient”; a total of 125 referrals between specialists were avoided, and in 23% of cases “there was a significant chance of reducing future drug costs”, according to the paper.
The research also showed that MDT discussions facilitated faster diagnosis and initiation of disease management, as well as better communication between rheumatology and IBD clinical teams.
“This study has identified several benefits from hosting regular SpA-IBD MDT meetings,” the authors concluded, and suggested that “other gastroenterology and rheumatology departments might consider implementing a similar multidisciplinary and multi-specialty approach”.