Integrated multidisciplinary care for the management of chronic conditions in adults: an overview of reviews and an example of using indirect evidence to inform clinical practice recommendations in the field of rare diseases

摘要: Background Integrated care models have been adopted for individuals with chronic conditions and persons rare diseases, such as haemophilia. Objective To summarize the evidence from reviews effects of integrated multidisciplinary in adults to provide an example using this make recommendations haemophilia care. Search methods We searched MEDLINE, EMBASE, CINAHL Cochrane Database Systematic Reviews up January 2016, reviewed reference lists retrieved papers. Selection criteria Systematic at least one randomized study, on non-communicable conditions. Data collection analysis Two investigators independently assessed eligibility extracted data. Quality was ROBIS, GRADE. Results We included seven reporting three conditions. We found low high quality evidence. Integrated results a reduction mortality; likely emergency visits improvement function; little no difference life, but shorter hospital stays; may result missed days school or work. No studies reported educational attainment, patient adherence knowledge. When used haemophilia, judgment about indirectness driven by disease, intervention outcome characteristics. Conclusion This overview provides most date adults, how it can be guidelines diseases.