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Colaboración interprofesional para mejorar la práctica profesional y los resultados de la atención sanitaria

Appendices

Appendix 1. CENTRAL search strategy

#1[mh "Interprofessional Relations"] and (collaborat* or team*)

#2 [mh "Patient Care Team"] and (collaborat* or team*)

#3 ((interprofession* or inter‐profession*) next (collaborat* or team*))

#4 ((interdisciplin* or inter‐disciplin*) next (collaborat* or team*))

#5 ((interoccupation* or inter‐occupation*) next (collaborat* or team*))

#6 ((multiprofession* or multi‐profession*) next (collaborat* or team*))

#7 ((multidisciplin* or multi‐disciplin*) next (collaborat* or team*))

#8((multioccupation* or multi‐occupation*) next (collaborat* or team*))

#9((transdisciplin* or trans‐disciplin*) next (collaborat* or team*))

#10(team* next collaborat*)

#11{or #1‐#10}

Appendix 2. MEDLINE search strategy

1 exp Interprofessional Relations/ and (collaborat$ or team$).tw. (8220)

2 exp Patient Care Team/ and (collaborat$ or team$).tw. (13439)

3 ((interprofession$ or inter‐profession$) adj (collaborat$ or team$)).tw. (853)

4 ((interdisciplin$ or inter‐disciplin$) adj (collaborat$ or team$)).tw. (2660)

5 ((interoccupation$ or inter‐occupation$) adj (collaborat$ or team$)).tw. (0)

6 ((multiprofession$ or multi‐profession$) adj (collaborat$ or team$)).tw. (355)

7 ((multidisciplin$ or multi‐disciplin$) adj (collaborat$ or team$)).tw. (7856)

8 ((multioccupation$ or multi‐occupation$) adj (collaborat$ or team$)).tw. (0)

9 ((transdisciplin$ or trans‐disciplin$) adj (collaborat$ or team$)).tw. (105)

10 (team$ adj collaborat$).tw. (158)

11 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 (26183)

12 randomized controlled trial.pt. (276233)

13 controlled clinical trial.pt. (42446)

14 randomized controlled trials/ (83918)

15 random allocation/ (45887)

16 double blind method/ (80591)

17 single blind method/ (16519)

18 12 or 13 or 14 or 15 or 16 or 17 (452549)

19 animals/ not humans/ (1793680)

20 18 not 19 (410246)

21 11 and 20 (954)

22 limit 21 to yr="2007 ‐Current" (595)

Appendix 3. CINAHL search strategy

1 (MH "Interprofessional Relations+") AND TX ((collaborat* or team*))

2 (MH " Multidisciplinary Care Team+") AND TX ((collaborat* or team*))

3 TX ((interprofession* or inter‐profession*) N1 (collaborat* or team*))

4 TX ((interdisciplin* or inter‐disciplin*)) N1 (collaborat* or team*))

5 TX ((interoccupation* or inter‐occupation*) N1 (collaborat* or team*))

6 TX ((multiprofession* or multi‐profession*) N1 (collaborat* or team*))

7 TX ((multidisciplin* or multi‐disciplin*) N1 (collaborat* or team*))

8 TX ((multioccupation* or multi‐occupation*) N1 (collaborat* or team*))

9 TX ((multioccupation* or multi‐occupation*) N1 (collaborat* or team*))

10 TX ((transdisciplin* or trans‐disciplin*) N1 (collaborat* or team*))

11 TX team* N1 collaborat*

12 S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10 OR S11

13 (MH "Clinical Trials+")

14 PT Clinical trial

15 TX ( (trebl* n1 blind*) or (trebl* n1 mask*) )

16 TX ( (tripl* n1 blind*) or (tripl* n1 mask*) )

17 TX ( (doubl* n1 blind*) or (doubl* n1 mask*) )

18 TX ( (singl* n1 blind*) or (singl* n1 mask*) )

19 TX randomi* control* trial*

20 (MH "Random Assignment")

21 TX random* allocat*

22 TX placebo*

23 (MH "Placebos")

24 (MH "Quantitative Studies")

25 TX allocat* random*

26 S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19 OR S20 OR S21 OR S22 OR S23 OR S24 OR S25

27 S12 AND S26

28 S12 AND S26. Limiters ‐ Publication Year: 2007‐2014; Clinical Trial

Appendix 4. ClinicalTrials.gov and ICTRP search strategies

ClinicalTrials.gov search strategy

(collaboration OR team) AND (interdisciplinary OR interprofessional OR multidisciplinary OR multiprofessional)

ICTRP search strategy

#1 collaboration AND interdisciplinary

#2 collaboration AND interprofessional

#3 collaboration AND multidisciplinary

#4 collaboration AND multiprofessional

#5 team AND interdisciplinary

#6 team AND interprofessional

#7 multidisciplinary team

#8 team AND multiprofessional

#9 OR/1‐8

Flow diagram of study selection
Figures and Tables -
Figure 1

Flow diagram of study selection

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'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies, based on EPOC methods.
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Figure 2

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies, based on EPOC methods.

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'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study, based on EPOC methods.
Figures and Tables -
Figure 3

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study, based on EPOC methods.

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Summary of findings for the main comparison. Effects of practice‐based interprofessional collaboration (IPC) interventions on professional practice and healthcare outcomes compared to usual care

Effects of practice‐based interprofessional collaboration (IPC) interventions on professional practice and healthcare outcomes compared to usual care

Patient or population: health and social care professionals involved in the delivery of health services and patient care
Settings: primary, secondary, tertiary and community care settings, primarily in the USA and the UK
Intervention: practice‐based interprofessional collaboration (IPC) interventions with an explicit objective of improving collaboration between two or more health or social care professionals
Comparison: usual care

Outcomes

Impacts

No. of studies (participants)

Certainty of the evidence
(GRADE)

Patient health outcomes

Patient functional status

Externally facilitated interprofessional activities may slightly improve stroke patients' functional status (Strasser 2008).

1

(464)

⊕⊕⊖⊖

Lowa

Patient‐assessed quality of care

It is uncertain if externally facilitated interprofessional activities increases patient‐assessed quality of care because the certainty of this evidence is very low (Black 2013).

1

(1185)

⊕⊖⊖⊖

Very lowb

Patient mortality, morbidity or complication rates

None of the included studies reported patient mortality, morbidity or complication rates.

‐‐

‐‐

Clinical process or efficiency outcomes

Adherence to recommended practices

The use of interprofessional activities with an external facilitator or interprofessional meetings may slightly improve adherence to recommended practices and prescription of drugs (Cheater 2005; Deneckere 2013; Schmidt 1998).

3

(2576)

⊕⊕⊖⊖

Lowc

Continuity of care

It is uncertain if externally facilitated interprofessional activities improves continuity of care because the certainty of this evidence is very low (Strasser 2008).

1

(464)

⊕⊖⊖⊖

Very lowd

dUse of healthcare resources

Interprofessional checklists (Calland 2011), interprofessional rounds (Curley 1998; Wild 2004) or externally facilitated interprofessional activities (Strasser 2008), may slightly improve overall use of resources, length of hospital stay, or costs.

4

(1679)

⊕⊕⊖⊖

Lowe

Collaborative behaviour outcomes

Collaborative working; team communication; team co‐ordination

It is uncertain whether externally facilitated interprofessional activities (Black 2013; Calland 2011; Cheater 2005; Deneckere 2013) improve collaborative working, team communication, and co‐ordination because the certainty of this evidence is very low.

4

(1936)

⊕⊖⊖⊖

Very lowf

GRADE Working Group grades of evidence
High‐certainty: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate‐certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very‐certainty: We are very uncertain about the estimate.

a We assessed the certainty of the evidence as low because of high risk of bias (no blinding of outcome assessment).

b We assessed the certainty of the evidence as very low because of the risk of bias (high risk of attrition and detection bias; details about allocation sequence generation and concealment were not reported).

c We assessed the certainty of the evidence as low due to potential indirectness (both studies were conducted in one country and the outcomes may not be transferable to other settings), and risk of bias (high risk of attrition, unclear selection and reporting risk).

d We assessed the certainty of the evidence as very low because of risk of bias (high risk of attrition and detection bias, and unclear risk of selection bias).

e We assessed the certainty of evidence as low because of high risk of bias (attrition and detection), and unclear risk of bias (selection, reporting, and contamination).

f We assessed the certainty of the evidence as very low due to high risk of bias (selection, attrition, and detection) or unclear risk of bias (reporting and contamination).

Figures and Tables -
Summary of findings for the main comparison. Effects of practice‐based interprofessional collaboration (IPC) interventions on professional practice and healthcare outcomes compared to usual care
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Summary of findings 2. Effects of practice‐based interprofessional collaboration (IPC) interventions on professional practice and healthcare outcomes compared with alternative IPC intervention

Effects of practice‐based interprofessional collaboration (IPC) interventions on professional practice and healthcare outcomes compared with alternative IPC intervention

Patient or population: health and social care professionals involved in the delivery of health services and patient care

Settings: two hospitals in Australia

Intervention: multidisciplinary video conferencing

Comparison: multidisciplinary audio conferencing

Outcomes

Impacts

No. of
studies
(participants)

Certainty of the evidence (GRADE)

Patient health outcomes

The study did not report patient health outcomes.

‐

‐

Clinical process or efficiency outcomes

Video conferencing may reduce the average length of treatment, compared to audio conferencing and may improve process/efficiency outcomes by reducing the number of multidisciplinary conferences needed per patient and patient length of stay.

1 (100)

⊕⊕⊖⊖

Lowa

Collaborative behaviour outcomes

There was little or no difference between the interventions in the number of communications between health professionals.

1 (100)

⊕⊕⊖⊖

Lowa

GRADE Working Group grades of evidence
High‐certainty: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate‐certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low‐certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low‐certainty: We are very uncertain about the estimate.

a We assessed the certainty of evidence as low because of high risk of bias (attrition and detection) and unclear risk of bias (selection, reporting, and contamination).

Figures and Tables -
Summary of findings 2. Effects of practice‐based interprofessional collaboration (IPC) interventions on professional practice and healthcare outcomes compared with alternative IPC intervention
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