“It’s like a OneStopShop”: A Qualitative Study Exploring Patient Experiences in Receiving Interdisciplinary Team-Based Care for Rheumatic and Musculoskeletal Diseases
Bibliographic record
Abstract
Objectives Given the rising prevalence and management complexity of rheumatic and musculoskeletal diseases (RMDs), evidence-informed solutions are needed to provide high-quality care within the available workforce. Interdisciplinary team-based models of rheumatology care, defined as rheumatologist and 1 or more interdisciplinary health professionals (eg, physical therapists, occupational therapists, nurses) working collaboratively to deliver care, provide a promising solution, however there is limited understanding of patients’ experiences with this approach. We aimed to 1) explore the experiences of patients living with RMDs receiving interdisciplinary team-based care, and 2) understand patients’ perceptions of how team-based care impacts their rheumatic disease management. Methods Informed by qualitative description, this study was a secondary analysis of qualitative interviews collected as part of an implementation science case study of the Center of Arthritis Research Excellence (CArE), an interdisciplinary rheumatology care model in Newmarket, Ontario, Canada. Participants were purposively sampled for diversity in age, disease duration, gender, and geographic location. Interviews, lasting 45-60 minutes, included questions pertaining to patients’ experiences with team-based care and perceptions of impact on disease management. We inductively coded interview transcripts and constructed themes using thematic analysis. Results Fifteen participants were interviewed, 47% identified as female. Ten (67%) had inflammatory arthritis, 3 (20%) had other inflammatory rheumatic disease, and 2 (13%) had osteoarthritis. We constructed 2 overarching themes: 1) Improved Access to Care and 2) Comprehensive Care (Table 1). Participants described how an interdisciplinary rheumatology team resulted in improved access to diverse healthcare expertise, enhancing overall care efficiency. Team-based care led to quicker responses from interdisciplinary providers compared to traditional practices, according to participants. They perceived that a team-based model resulted in a holistic approach to care, addressing needs beyond what rheumatologists alone could offer. Extended consultations facilitated in-depth assessments, education, and support across all aspects of disease management. Participants appreciated the integrated “one-stop-shop” model, which minimized external referrals and reduced the number of appointments. The interdisciplinary approach fostered patient engagement, self-advocacy, and shared decision-making. Table 1. Themes and subthemes with illustrative quotes. Conclusion This study highlights the experiences of patients living with RMDs receiving care within an interdisciplinary team-based model of rheumatology care. A team-based approach was valued by patients for improving care access and providing comprehensive management through complementary expertise, resulting in greater efficiency and holistic management of their RMDs. These results support the increased use of interdisciplinary team-based models in rheumatology care. Future studies should explore patient experiences with team-based care across different sites and team structures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.012 | 0.012 |
| Scholarly communication | 0.006 | 0.007 |
| Open science | 0.003 | 0.007 |
| Research integrity | 0.003 | 0.006 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".