A scoping review to identify strategies and interventions improving interprofessional collaboration and integration (IPCI) in primary care.

Muhammed Mustafa Sirimsi, Hans De Loof, Kris Van Den Broeck, Kristel De Vliegher, Peter Van Bogaert

Keywords: Interprofessional collaboration, primary care, integrated care, general practice, intervention

Background:
As the world population is aging, the increased health care needs and its growing complexity and cost, are prompting a fundamental rethink of primary care organization. Researchers and the government are convinced that interprofessional collaboration and integration among primary care workers can counteract these challenges and problems.

Research questions:
Which strategies and interventions are used to improve interprofessional collaboration and integration in primary care?

Method:
We conducted a scoping review using the Arksey & O’Malley framework and the PRISMA Guidelines. Specific Medical Subject Headings (MeSH-terms) were used, and a search strategy was developed for Pubmed and subsequently adapted to Medline, Eric and Web of Science. Articles were included if they: (i) were in English, (ii) described an intervention to improve interprofessional collaboration or integration (IPCI) in primary care involving at least two different healthcare disciplines, (iii) originated from a high-income country, (iv) were peer reviewed; and (v) were published between 2001 and 2020.

Results:
The literature search yielded a total of 1816 papers. After removing duplicates, screening titles and abstracts, and performing full text readings, 34 papers describing strategies and interventions to facilitate IPCI in primary care were incorporated in this scoping review. The identified strategies and interventions are categorised under five main themes; (i) Acceptance and team readiness towards collaboration, (ii) acting as a team and not as an individual; (iii) communication strategies and shared decision making, (iv) coordination in primary care, and (v) integration of caregivers and their skills and competences.

Conclusions:
We identified a mix of strategies and interventions that can function as ‘building blocks’, for the development of a generic intervention to improve collaboration in different settings and levels of primary care.

Points for discussion:
Acceptancy and team readiness towards interprofessional collaboration is a prerequisite to achieve a collaborative practice.

When and how can interprofessional collaboration be beneficial for the patient?

To enhance and maintain a cooperative behaviour, development of shared principles such as a shared vision, values and goals are needed.