[Assessment of the Internal Medicine Multidisciplinary Team meetings at the Grenoble University Hospital]

Rev Med Interne. 2021 Jul;42(7):452-458. doi: 10.1016/j.revmed.2020.11.013. Epub 2020 Dec 10.
[Article in French]

Abstract

Introduction: Multidisciplinary team (MDT) meetings purpose is to optimize the disease management regarding state of science. While cancer MDT has proven its effectiveness, this is not yet the case with internal medicine MDT.

Methods: We performed a descriptive monocentric retrospective study. Data were collected from 247 MDT meeting reports which took place at the Grenoble University Hospital over a 5 years period. We investigated the data related to patient, MDT features, and decision-making process and reporting. Discussions were classified as diagnostic and/or therapeutic.

Results: Three specialties, among which at least internal medicine, attended to meetings. While 12% of cases were considered as "complex", a specialist opinion was required in 18% of diagnostic discussions. With regards to therapeutic discussions, 35% were supported by guidelines, 50% of therapeutic implementation involved innovating and expensive drugs, with off-label prescription in 75% of them. The decision-making process was described in 6% of the reports. Treatment recommendations were actually implemented in 72% of the patients.

Conclusion: MDT meetings in Internal medicine meets a real need of physicians, in the ultimate interest of the patient. A prospective analysis would be interesting for a better definition of the evaluation criteria of these MDT meetings, meeting the physicians' needs, in patient management best interest. Prospective analyses are needed to better define MDT meetings assessment criteria.

Keywords: Biotherapy; Biothérapies; Hors-AMM.; Innovating and expensive therapeutics; Internal medicine; Multidisciplinary team meetings; Médecine interne; Off-label; Réunion de concertation pluridisciplinaire; Thérapeutiques onéreuses.

MeSH terms

  • Hospitals, University
  • Humans
  • Internal Medicine
  • Neoplasms*
  • Patient Care Team*
  • Retrospective Studies