Perceived Barriers, Benefits, Facilitators, and Attitudes of Health Professionals towards Multidisciplinary Team Care in Type 2 Diabetes Management: a Systematic Review.

BACKGROUND The need for a multidisciplinary team approach to provide physical exercise, diet, behavioral change and insulin therapy in type 2 diabetes mellitus (T2DM) treatment has long been recognized. However, often patients with T2DM do not have access to a multidisciplinary team. INTRODUCTION In developing countries most patients with T2DM receive their diabetes care in the office of an internist or family practice physician or in a primary level health center with a general practitioner. Knowing the perceived barriers, attitude, facilitators, and benefits in healthcare professionals toward multidisciplinary team approach in T2DM treatment can help to facilitate implementation of multidisciplinary care in T2DM. METHODS A systematic search strategy was performed in six databases (PubMed, Web of Science, CINAHL, EMBASE, MEDLINE, and Cochrane) using different keyword combinations to identify studies describing healthcare professionals' views of multidisciplinary team care in T2DM. Textual narrative synthesis was used to analyse data. The Critical Appraisals Skills Programme (CASP) tool for qualitative studies was used to assess risk of bias and transferability. RESULTS The views of health professionals about multidisciplinary team care in T2DM were categorized into six major factors namely: working collaboratively to foster supportive relationships; strong committed organizational and team leadership; diversity in expertise, with team members tailored to local circumstances; shared goals and approaches to ensure consistency of message; clear and open communication with the team and with patients; and the patient at the center of decision-making. CONCLUSIONS There is a huge gap in shared roles among health professionals in T2DM therapy. Hence, there is need for allied health professionals such as physiotherapists, dieticians, and psychologists with expertise in diabetes to explore primary healthcare. Barriers and facilitators for successful integration of multidisciplinary team, seamlessly cut across three hierarchal levels namely, health management; health professionals; and diabetic patients.