Team-Based Outpatient Rheumatology Care: A Scoping Review of Terminology, Team Composition, and Impact on Advancing...

Team-based models of rheumatology care are increasingly recognized to improve outcomes across the Quintuple Aim, yet the evidence remains fragmented. This scoping review aimed to map the evidence on team-based outpatient rheumatology care across all domains of the Quintuple Aim (population health, patient experience, costs, provider well-being, and health equity).

This scoping review followed Joanna Briggs Institute methodology and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist. We searched MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and CINAHL from inception to May 2024. We included peer-reviewed studies comparing outpatient team-based rheumatology care, involving at least 1 rheumatologist and 1 interdisciplinary healthcare provider, to other models of care. Terminology describing care models was examined in relation to reported team composition and outcomes were mapped to the Quintuple Aim targets.

The search identified 6139 unique records, of which 76 reports representing 67 studies met inclusion criteria. Team-based models most frequently involved a rheumatologist and a nurse, although team composition varied widely. Terminology used to describe care models was inconsistent, and care delivery descriptions often lacked sufficient detail to allow replication. Most studies focused on clinical outcomes and patient experience, whereas few included economic, equity, or provider-related outcomes.

This review highlights wide variation in team composition, collaboration, and terminology in team-based rheumatology care models. Advancing the field will require standardized terminology, detailed reporting of team roles and processes, and rigorous long-term cost-effectiveness evaluations to fully assess impact across all domains of the Quintuple Aim.