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Effect of Multidisciplinary Team Care on Treatment Adherence among Patients with Chronic Diseases in Nigeria

Abstract

Chronic diseases remain a major public health concern in Nigeria and often require long-term treatment, regular monitoring, lifestyle modification, and continuous interaction with healthcare providers. Patients living with conditions such as hypertension, diabetes, chronic respiratory diseases, cardiovascular diseases, and other long-term illnesses may experience difficulties adhering to prescribed medications and treatment plans due to complex treatment regimens, inadequate health information, financial constraints, medication side effects, limited follow-up, poor coordination of care, and challenges accessing healthcare services. Multidisciplinary team care brings together healthcare professionals from different disciplines to coordinate patient management, provide comprehensive care, support treatment decisions, and address the multiple needs of patients with chronic diseases. Effective coordination among healthcare professionals may improve patients' understanding of their treatment, strengthen follow-up, and encourage adherence to prescribed care. Against this background, this study investigates the effect of multidisciplinary team care on treatment adherence among patients with chronic diseases in Nigeria. The study will be anchored on the Chronic Care Model, the Health Belief Model, and the Donabedian Model of Healthcare Quality. The Chronic Care Model emphasizes coordinated healthcare teams, patient self-management support, clinical information systems, decision support, and organized healthcare delivery as essential components of effective chronic disease management. The Health Belief Model explains how patients' perceptions of disease susceptibility, severity, treatment benefits, barriers, and cues to action may influence their adherence to recommended treatment. The Donabedian Model explains how healthcare structures and care processes influence treatment outcomes, with multidisciplinary team organization representing an important component of healthcare delivery. Collectively, these theoretical perspectives provide a suitable framework for explaining how multidisciplinary team care may influence treatment adherence among patients with chronic diseases in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cohort research design. The study population will comprise adult patients diagnosed with selected chronic diseases and receiving long-term treatment at selected public and private healthcare facilities in Nigeria. A multistage sampling technique will be used to select states, local government areas, healthcare facilities, specialist clinics, and eligible patients. Multidisciplinary team care will be measured using indicators such as availability of a coordinated healthcare team, involvement of physicians, nurses, pharmacists, nutritionists, physiotherapists, social workers, or other relevant professionals, frequency of team consultations, care-plan coordination, medication review, patient education, treatment monitoring, referral coordination, follow-up communication, and documentation of multidisciplinary interventions. Treatment adherence will be assessed using indicators such as medication-taking behaviour, adherence to prescribed treatment schedules, attendance at follow-up appointments, adherence to recommended lifestyle modifications, completion of laboratory monitoring, adherence to dietary recommendations where applicable, missed doses, treatment discontinuation, and patient-reported adherence. Where appropriate, objective measures such as pharmacy refill records, prescription records, treatment registers, and clinical records will complement self-reported adherence measures. Data will be collected using structured questionnaires, validated treatment-adherence instruments, patient medical records, pharmacy records, appointment registers, and multidisciplinary care documentation. Descriptive statistics will be used to summarize patients' demographic and clinical characteristics, multidisciplinary care exposure, and treatment-adherence patterns. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of multidisciplinary team care on treatment adherence. Where a quasi-experimental design is adopted, adherence before and after implementation of multidisciplinary team care or between patients receiving multidisciplinary and standard care may be compared. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that multidisciplinary team care has a significant positive effect on treatment adherence among patients with chronic diseases in Nigeria. Patients receiving coordinated multidisciplinary care are expected to demonstrate better adherence to prescribed medications, treatment schedules, follow-up appointments, lifestyle recommendations, and required monitoring compared with patients receiving less coordinated care. Collaboration among healthcare professionals may improve medication management, identify treatment-related problems, provide consistent health education, address financial and social barriers, and strengthen patient follow-up. Regular communication among team members may also reduce conflicting treatment instructions and improve continuity of care. However, inadequate healthcare staffing, limited availability of specialized professionals, poor communication systems, fragmented healthcare services, financial constraints, high patient workload, and insufficient institutional support may reduce the effectiveness of multidisciplinary care. The study therefore expects well-coordinated, patient-centred, and adequately supported multidisciplinary team care to contribute significantly to improved treatment adherence among patients with chronic diseases in Nigeria. The study is expected to contribute to the literature on multidisciplinary team care, treatment adherence, chronic disease management, coordinated healthcare, medication adherence, patient-centred care, continuity of care, healthcare quality, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, primary healthcare facilities, professional healthcare associations, healthcare managers, physicians, nurses, pharmacists, nutritionists, physiotherapists, social workers, development partners, and policymakers regarding strategies for improving long-term chronic disease management. The study will also provide evidence-based recommendations for strengthening multidisciplinary healthcare teams, improving communication and care coordination, integrating pharmacists and other relevant professionals into chronic disease management, strengthening patient education and follow-up systems, and developing sustainable multidisciplinary care models for patients with chronic diseases across Nigeria.

Keywords: Multidisciplinary team care, treatment adherence, chronic diseases, medication adherence, coordinated healthcare, chronic disease management, patient-centred care, continuity of care, healthcare quality, Nigeria, public health.