Evidence for the urogynaecology multidisciplinary team meeting: evaluation from a secondary care perspective

Introduction Urogynaecology multidisciplinary team (MDT) meetings to discuss management plans prior to invasive treatments for urinary incontinence have been recommended by guidelines in the UK since 2013. Evidence for MDT discussion in urogynaecology is lacking, with only two published studies. The aim of this study was to evaluate the cases discussed at a secondary care urogynaecology MDT meeting, to establish types of clinical problems discussed, assess the outcomes of the MDT meeting and compare this with existing evidence for MDT meetings in urogynaecology. Methods A retrospective review of meeting minutes and all case notes for patients discussed at 12 MDT meetings over 13 months was carried out. Data collected included attendance from different staff groups, reasons for referral, outcome of discussions, and changes to management plans. Results A total of 123 cases were discussed over 12 meetings, 7 members of staff attended each meeting on average. 63% of cases were referred for discussion of a primary problem. The majority of patients were referred for discussion of management of urinary incontinence prior to invasive procedures (57%). The agreed MDT plan corresponded with proposed management in 67% of cases, with changes to management plan in 31% of cases. Conclusion Refinements to management plans in this study highlight the importance of MDT input in urogynaecology care and mirror the findings of two previous studies. Evidence for improved outcomes and the cost-effectiveness of MDTs is lacking and is an area for future research. Expanded national guidance for urogynaecology MDTs is likely to require local and regional restructuring of these in the UK.