Perceptions of Rheumatologists on Barriers and Enablers to Adoption of Interdisciplinary Models of Care in Rheumatology in Ontario, Canada

OBJECTIVE: Interdisciplinary models of care, where rheumatologists provide care collaboratively with interdisciplinary healthcare professionals (IHPs), can enhance rheumatology service delivery, yet their adoption remains limited. This study aimed to identify barriers and enablers to adopting an interdisciplinary model of care, as perceived by rheumatologists. METHODS: We conducted semi-structured interviews with rheumatologists practicing without IHP support in Ontario, Canada. The interview guide was informed by the Theoretical Domains Framework (TDF), an implementation framework used to identify determinants of health-professional behaviour. Content analysis was used to deductively code data to TDF domains and to inductively derive within-domain themes related to factors influencing adoption of interdisciplinary care. RESULTS: We interviewed 14 rheumatologists. Seven TDF domains were relevant to adoption of interdisciplinary care: Optimism, Beliefs about Capabilities, Beliefs about Consequences, Reinforcement, Environmental Context and Resources, Knowledge, and Skills. Rheumatologists reported optimism that interdisciplinary models would achieve desired outcomes, felt confident in training IHPs, and anticipated benefits for patients and rheumatologists. These factors, together with prior positive experience with interdisciplinary teams, were seen as key enablers of adoption. Barriers included insufficient funding, space constraints, limited availability of trained IHPs, and turnover risk. Most rheumatologists reported gaps in knowledge of IHP training and scope, and limited business skills for recruitment/hiring. CONCLUSION: This study identified behavioural determinants of rheumatologists' adoption of an interdisciplinary model of care. To overcome barriers and strengthen enablers, sustainable funding, IHP workforce development, practical implementation resources (business guidance and training), and clear blueprints of successful care models including IHP role descriptions, are required.