First insights into multidisciplinary and multispecialty long COVID networks—a SWOT analysis from the perspective of... 2023 Stengel et al

Full title: First insights into multidisciplinary and multispecialty long COVID networks—a SWOT analysis from the perspective of ambulatory health care professionals

Introduction: Multidisciplinary and multispecialty approaches with central integration of primary care, individualized long-term rehabilitative care, and multidisciplinary care pathways are recommended by international consortia to face the challenges of care of long COVID. Two regional long COVID networks—Rhein-Neckar (RN) and Ludwigsburg (LU) have emerged as ad hoc examples of best practice in Southern Germany. The aim of the community case study is to provide first insights into the experiences of the networks.

Methods: The exploratory observational study was conducted between April and June 2023, focusing on an observation period of just under 24 months and using a document analysis supported by MAXQDA and SWOT analysis with ambulatory health care professionals in two online group discussions.

Results: The document analysis revealed that both networks have defined network participants who have agreed on common goals and patient pathways and have established ways of communicating, organizing, and collaborating. Both networks agreed on a primary care-based, multidisciplinary and multispecialty approach. The main differences in realization emerged in LU as a focus on the ambulatory setting and very concrete application to individual patients, while RN showed a focus on an intersectoral character with participation of the specialized university hospital sector, knowledge transfer and a supra-regional approach with the involvement of the meso and macro level. The SWOT analysis (n = 14 participants, n = 6 male, 7 physicians (4 disciplines), 7 therapists (5 professions)) showed strengths such as resulting collaboration, contribution to knowledge transfer, and improvement of care for individual patients. As barriers, e.g., lack of reimbursement, high efforts of care, and persistent motivation gaps became apparent. Potentials mentioned were, e.g., transferability to other diseases such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, promotion of addressing a “difficult topic” and promotion of intersectoral care concepts; risks mentioned were, e.g., limited network resources and negative effects on the development of other structures.

Conclusion: Resulting implications for practice and research address a call to policy makers and funders to support further research to find out what generalizable results regarding usefulness, effectiveness, and efficiency including transferability to other post-infectious diseases can be derived.

Open access, https://www.frontiersin.org/articles/10.3389/fmed.2023.1251915/full

 

What does SWOT stand for?

 

Thank you, @NelliePledge

 

Lots of words in a report that will not make a difference and mostly amounts to the bureaucratic version of patients' report of "I went to the clinic, they were very nice but it made no difference, they had nothing to offer that was helpful and I am no better off, just coping and hoping that chance is on my side".

It's the usual "we did things, here are the things we did, we don't know if they're useful, we hope that they are, we think that they are". Those services have no ability to assess their own performance, and are not interested in honest reports from patients because those reports do not support their hope that they are doing something worth doing in its current form, which seems to be the only thing that matters here. They want the 'multidisciplinary' rehabilitation model to work, just because they want it to work, not because it's what's needed, or has anything to do with the problems.

Research is needed. Basic research. Real biomedical research that deals with the causes and can produce effective treatments. There is no need to "research" this treatment model, they don't have treatments and have no ability to come up with or assess the efficacy of treatments using a pragmatic, or as they say ad hoc, approach. Obviously, the alternative medicine model of "let's just try stuff and hope that the hope that it works is good enough to help" will never work here, but they can't accept that for truly inexplicable reasons.