ABSTRACT
Background : Information regarding the effect of a
multidisciplinary team (MDT) to improve cardiometabolic risk factors
(CMRF) in routine clinical settings is lacking.
Methods : In this one-year retrospective chart review (2018),
598 adults (African American 59%, Hispanic 35%, Caucasian 6%) with a
mean age of 43.8 ± 14.0 were included. Qualifying patients (≥ 1 CMRF of
overweight/obesity, prediabetes/diabetes, or hypertension) who were
treated under an MDT protocol were compared to patients who qualified
for MDT but were treated solely by a primary care provider (PCP). The
MDT protocol included endocrinology-oriented visits, lifestyle
counseling, care coordination, and shared medical appointments. Linear
and binary regression were performed to identify the factors associated
with CMRF changes.
Results : Patients treated by MDT had a greater reduction (β,
95% CI) in weight (- 4.29 kg, -7.62, -0.97), BMI (-1.43
kg/m2, -2.68, -0.18), SBP (- 2.18 mmHg, -4.09, -0.26),
and DBP (- 1.97 mmHg, -3.34, -0.60). They also had 77% higher odds of
reducing ≥ 5% their initial weight, 83% higher odds of reducing 1
point of BMI, and 59% higher odds of reducing ≥2 mmHg DBP. No
association was observed for MDT intervention and A1c changes.
Conclusion: Compared to PCP, MDT-protocolized intervention
improves CMRF in a multi-ethnic adult cohort in a routine clinical
setting. Patient’s activation to access the best care and overcoming
barriers from patients (weight perception, social determinants
increasing no-shows to visits), providers (obesity stigma, clinical
inertia), and health system (time constraints and high paperwork imposed
by payers) is a priority.