Giannoula Tsakitzidis

Outcome Indicators on Interprofessional Collaboration Interventions for Elderly

Background: Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population. Method: A systematic review is performed in the Cochrane Library, Pubmed (Medline), Embase, Cinahl and Psychinfo with a search until June 2014. Results: Overall, 689 references were identified of which 29 studies met the inclusion criteria. All outcome indicators were summarized in three categories: collaboration, patient level outcome and costs. Seventeen out of 24 outcome indicators within the category of ‘collaboration’ reached significant difference in advantage of the intervention group. On ‘patient outcome level’ only 15 out of 32 outcome parameters met statistical significance. In the category of ‘costs’ only one study reached statistical significance. Discussion and conclusion: The overall effects of interprofessional interventions for elderly are positive, but based on heterogeneous outcomes. Outcome indicators of interprofessional collaboration for elderly with a significant effect can be summarized in three main categories: ‘collaboration’, patient level’ and ‘costs’. For ‘collaboration’ the outcome indicators are key elements of collaboration, involved disciplines, professional and patient satisfaction and quality of care. On ‘patient level’ the outcome indicators are pain, fall incidence, quality of life, independence for daily life activities, depression and agitated behaviour, transitions, length of stay in hospital, mortality and period of rehabilitation. ‘Costs’ of interprofessional interventions on short- and long-term for elderly need further investigation. When organizing interprofessional collaboration or interprofessional education these outcome indicators can be considered as important topics to be addressed. Overall more research is needed to gain insight in the process of interprofessional collaboration and so to learn to work interprofessionally.

The Role of Interprofessional Communication in Pharmaceutical Care

Pharmaceutical care can hardly be provided without collaboration with other healthcare providers. In its optimal form, interprofessional collaboration entails that providers discuss mutual goals, resources, and responsibility for patient care. In order to support this collaboration, interprofessional education is essential. Collaborating in healthcare is a competency and can be learned. One of the central elements in the competence “collaborator in healthcare” is interprofessional communication. This competency is characterized by different aspects, which apply whatever the medium used.

6 Aspecifieke nekpijnen: diagnose en behandeling in het kader van evidence-based medicine

» In de literatuur is er geen eenduidige definitie voor aspecifieke nekpijn (ANP) gevonden. Algemeen wordt aangenomen dat ANP kan worden gedefinieerd als elke vorm van acute, subacute of chronische nekpijn waarbij geen beschadigde of abnormale anatomische structuren kunnen worden geidentificeerd. In dit hoofdstuk worden de resultaten beschreven uit een systematische literatuurstudie, met als doel een EBM-aanpak (evidence-based medicine ) te implementeren in de klinische praktijk. Uit de resultaten is gebleken dat ANP een heterogeen gebruikte diagnose is waarbij anamnese en klinisch onderzoek aan te bevelen zijn, met de nadruk op het uitsluiten van ‘rode vlaggen’. Medische beeldvorming blijkt niet nuttig te zijn bij het diagnosticeren van aspecifieke nekpijn. Een multimodale behandeling, waarbij mobilisaties en/of manipulaties in combinatie met oefeningen (onder professionele begeleiding) worden gegeven, blijkt effectief te zijn bij volwassenen met aspecifieke nekpijn. Algemeen kan geconcludeerd worden dat verder onderzoek naar de diagnose en behandeling van ANP geindiceerd is.