MINI REVIEW article
Front. Med.
Sec. Family Medicine and Primary Care
Multidisciplinary Team Collaboration in Chronic Disease Management: A Mini-Review from the Perspective of Internal Medicine Nursing
Provisionally accepted
- Sichuan Nursing Vocational College, Chengdu, China
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The global epidemic of non-communicable diseases (NCDs) presents a central challenge to contemporary public health and healthcare systems. Traditional, physician-centric, and fragmented care models struggle to meet the complex, long-term needs of patients with chronic conditions. From the standpoint of internal medicine nursing, this mini-review synthesizes recent advancements and core concepts in integrated chronic disease management centered on the multidisciplinary team (MDT). It delineates the composition, operational mechanisms, and critical role of MDTs in improving patient outcomes and optimizing healthcare resource allocation. Furthermore, it explores variations in implementation models across different contexts, existing controversies and challenges, and analyzes current research gaps alongside future directions, including technology integration, role expansion, and value-based payment reform. This review emphasizes that internal medicine nurses, serving as coordinators, educators, and direct caregivers within the MDT, are indispensable agents for effective chronic disease management.
Keywords: Chronic disease management, Healthcare Model Innovation, InternalMedicine Nursing, Multidisciplinary Team Collaboration, Nursing Role Expansion
Received: 11 Jan 2026; Accepted: 13 Feb 2026.
Copyright: © 2026 Xu, Deng and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Aiqiu Xu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.