Background and Goal: Clinical integration involves coordinating ongoing health care services across health professionals, facilities, and support systems to meet patient care needs. Researchers aimed to map out barriers and facilitators perceived by family physicians in clinical integration to guide future intervention development.
Study Approach: Researchers examined systematic review studies published from 2010 to 2022. Researchers adopted a “best-fit framework approach” to organize findings into themes and subthemes. They then validated the framework with another 21 reviews published between 2022 and 2024.
Main Results: 90 reviews covering over 1,200 studies were included in the analysis
Researchers identified 9 themes related to operation units (system, organization, and practice); individuals (providers, family physicians, and patients); medicine and professional work (professional); beliefs, attitudes, stigma and culture (normative); and administrative management, finance, and communication (functional).
The professional theme appeared in 86% of the reviews, including subthemes related to diseases, roles and identities, clinical guidelines, and teamwork.
In contrast, system, organization, and practice-related themes were less frequently reported (48%, 22%, and 23%).
Four subthemes stood out for their popularity: family physicians’ characteristics, knowledge, and experience (78%); patients’ characteristics, knowledge, and experience (70%); beliefs and attitudes (62%); and roles and identities (60%).
Why It Matters: The study findings highlight the complex interactions between factors, subthemes, and overarching themes.Clinical leaders and decision makers must bear these factors in mind when experimenting with interventions, targeting common elements shared across themes to strengthen care integration.
Olivia L. Tseng, MD, PhD, MSc, et al
University of British Columbia, Vancouver, British Columbia, Canada
Centre for Clinical Epidemiology & Evaluation, Vancouver, British Columbia, Canada; Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
The Annals of Family Medicine