Impact of multiprofessional collaboration in primary care practices on continuity of care: a scoping review

Abstract Background Multiprofessional care in Primary Care practices is increasingly common. However, the presence of multiple professional roles in the practice team may affect continuity of care (CoC), whether through newly established multiprofessional teams or changes within existing team structures. CoC has been shown to decline in recent years contrasting to its core value for primary care. This scoping review aims to determine the effect of multiprofessional patient care within the primary care practice team on CoC, and to evaluate the extent and type of evidence. Methods A literature search was conducted using the databases PubMed, CINAHL, Embase, and the Cochrane Library. Peer-reviewed, original articles with either quantitative, qualitative or mixed methods design, with no limit on publication date and written in any language were considered. The search strings combined the three concepts: primary care, CoC and multiprofessional co-location. Studies were included if they examined any effect of multiprofessional care in a practice-based primary care setting on CoC, using a stepwise and hierarchical screening procedure of titles, abstracts and full-texts. Studies were analysed according to Haggerty et al.’s framework of informational, relational, and management domains of CoC. Results The initial search resulted in 6525 unique studies. The final dataset included 21 studies utilising data from 2010 onward. The studies suggest that CoC may suffer if care is provided by multiple professionals, foremost the relational domain of CoC, whereas informational and management CoC were generally maintained or even improved. For the relational CoC, expectations and concerns in regard with introducing new professional roles in the primary care practice varied between providers and patients, with more pronounced concerns among patients. Small, stable teams and practice sizes with strong communication were consistently mentioned as key facilitators of CoC. Conclusion The relationship between CoC and multiprofessional care is complex and context dependent. When new professional roles are introduced in primary care practice teams, multiprofessional care may offer the opportunity to maintain or even improve CoC. Importantly, expectations and concerns of providers and patients must be considered and addressed, especially for relational CoC which is a major concern for patients in the context of multiprofessional care.