Impact of a Multidisciplinary Approach on Cardiometabolic Risk Reduction in a Multiracial Cohort of Adults: A 1-Year Pilot Study

Evidence examining specific effects of a multidisciplinary team (MDT) on cardiometabolic risk factors (CMRFs) among multi-ethnic patients in real-world clinical settings is lacking. This one-year retrospective chart review (2018) analyzed 598 adults (African American 59%, Hispanic 35%, and Caucasian...

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Main Authors: Ramfis Nieto-Martínez, Andrés Velásquez-Rodríguez, Claudia Neira, Xichen Mou, Andres Neira, Gabriela Garcia, Pedro Velásquez-Rodríguez, Marian Levy, Jeffrey I. Mechanick, Pedro A. Velásquez-Mieyer
Format: Article
Language:English
Published: MDPI AG 2022-08-01
Series:Nutrients
Subjects:
Online Access:https://www.mdpi.com/2072-6643/14/16/3391
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author Ramfis Nieto-Martínez
Andrés Velásquez-Rodríguez
Claudia Neira
Xichen Mou
Andres Neira
Gabriela Garcia
Pedro Velásquez-Rodríguez
Marian Levy
Jeffrey I. Mechanick
Pedro A. Velásquez-Mieyer
author_facet Ramfis Nieto-Martínez
Andrés Velásquez-Rodríguez
Claudia Neira
Xichen Mou
Andres Neira
Gabriela Garcia
Pedro Velásquez-Rodríguez
Marian Levy
Jeffrey I. Mechanick
Pedro A. Velásquez-Mieyer
author_sort Ramfis Nieto-Martínez
collection DOAJ
description Evidence examining specific effects of a multidisciplinary team (MDT) on cardiometabolic risk factors (CMRFs) among multi-ethnic patients in real-world clinical settings is lacking. This one-year retrospective chart review (2018) analyzed 598 adults (African American 59%, Hispanic 35%, and Caucasian 6%) with mean age of 43.8 ± 14.0 years. Qualifying patients with primary inclusion criteria of having body mass indices and blood pressure (BP) measurements in the first and last quarter of the study period were treated under an MDT protocol and compared to those qualifying for MDT but treated solely by a primary care provider (PCP). MDT included endocrinologist-directed visits, lifestyle counseling, and shared medical appointments. MDT patients experienced a greater reduction (β; 95% CI) in weight (−4.29 kg; −7.62, −0.97), BMI (−1.43 kg/m<sup>2</sup>; −2.68, −0.18), systolic BP (−2.18 mmHg; −4.09, −0.26), and diastolic BP (−1.97 mmHg; −3.34, −0.60). Additionally, MDT patients had 77%, 83%, and 59% higher odds of reducing ≥5% of initial weight, 1 BMI point, and ≥2 mmHg DBP, respectively. Improvements in hemoglobin A1C measurements were observed in the MDT group (insufficient data to compare with the PCP group). Compared to PCP only, MDT co-management improves CMRF related to adiposity and hypertension in a multiethnic adult cohort in real-world clinical settings. Patient access to best practices in cardiometabolic care is a priority, including the incorporation of culturally adapted evidence-based recommendations translated within a multi-disciplinary infrastructure, where competing co-morbidities are better managed, and associated research and education programs can promote operational sustainability.
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spelling doaj.art-edaacdb19e8a474c90190ade9c73e1512023-11-30T22:08:27ZengMDPI AGNutrients2072-66432022-08-011416339110.3390/nu14163391Impact of a Multidisciplinary Approach on Cardiometabolic Risk Reduction in a Multiracial Cohort of Adults: A 1-Year Pilot StudyRamfis Nieto-Martínez0Andrés Velásquez-Rodríguez1Claudia Neira2Xichen Mou3Andres Neira4Gabriela Garcia5Pedro Velásquez-Rodríguez6Marian Levy7Jeffrey I. Mechanick8Pedro A. Velásquez-Mieyer9Lifedoc Health, Memphis, TN 38119, USALifeDOC Research, Memphis, TN 38119, USALifedoc Health, Memphis, TN 38119, USASchool of Public Health, The University of Memphis, Memphis, TN 38152, USALifedoc Health, Memphis, TN 38119, USALifedoc Health, Memphis, TN 38119, USADarSalud Management, Memphis, TN 38115, USASchool of Public Health, The University of Memphis, Memphis, TN 38152, USAThe Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USALifedoc Health, Memphis, TN 38119, USAEvidence examining specific effects of a multidisciplinary team (MDT) on cardiometabolic risk factors (CMRFs) among multi-ethnic patients in real-world clinical settings is lacking. This one-year retrospective chart review (2018) analyzed 598 adults (African American 59%, Hispanic 35%, and Caucasian 6%) with mean age of 43.8 ± 14.0 years. Qualifying patients with primary inclusion criteria of having body mass indices and blood pressure (BP) measurements in the first and last quarter of the study period were treated under an MDT protocol and compared to those qualifying for MDT but treated solely by a primary care provider (PCP). MDT included endocrinologist-directed visits, lifestyle counseling, and shared medical appointments. MDT patients experienced a greater reduction (β; 95% CI) in weight (−4.29 kg; −7.62, −0.97), BMI (−1.43 kg/m<sup>2</sup>; −2.68, −0.18), systolic BP (−2.18 mmHg; −4.09, −0.26), and diastolic BP (−1.97 mmHg; −3.34, −0.60). Additionally, MDT patients had 77%, 83%, and 59% higher odds of reducing ≥5% of initial weight, 1 BMI point, and ≥2 mmHg DBP, respectively. Improvements in hemoglobin A1C measurements were observed in the MDT group (insufficient data to compare with the PCP group). Compared to PCP only, MDT co-management improves CMRF related to adiposity and hypertension in a multiethnic adult cohort in real-world clinical settings. Patient access to best practices in cardiometabolic care is a priority, including the incorporation of culturally adapted evidence-based recommendations translated within a multi-disciplinary infrastructure, where competing co-morbidities are better managed, and associated research and education programs can promote operational sustainability.https://www.mdpi.com/2072-6643/14/16/3391multidisciplinaryobesityrisk factorsbody mass indexcardiometabolic
spellingShingle Ramfis Nieto-Martínez
Andrés Velásquez-Rodríguez
Claudia Neira
Xichen Mou
Andres Neira
Gabriela Garcia
Pedro Velásquez-Rodríguez
Marian Levy
Jeffrey I. Mechanick
Pedro A. Velásquez-Mieyer
Impact of a Multidisciplinary Approach on Cardiometabolic Risk Reduction in a Multiracial Cohort of Adults: A 1-Year Pilot Study
Nutrients
multidisciplinary
obesity
risk factors
body mass index
cardiometabolic
title Impact of a Multidisciplinary Approach on Cardiometabolic Risk Reduction in a Multiracial Cohort of Adults: A 1-Year Pilot Study
title_full Impact of a Multidisciplinary Approach on Cardiometabolic Risk Reduction in a Multiracial Cohort of Adults: A 1-Year Pilot Study
title_fullStr Impact of a Multidisciplinary Approach on Cardiometabolic Risk Reduction in a Multiracial Cohort of Adults: A 1-Year Pilot Study
title_full_unstemmed Impact of a Multidisciplinary Approach on Cardiometabolic Risk Reduction in a Multiracial Cohort of Adults: A 1-Year Pilot Study
title_short Impact of a Multidisciplinary Approach on Cardiometabolic Risk Reduction in a Multiracial Cohort of Adults: A 1-Year Pilot Study
title_sort impact of a multidisciplinary approach on cardiometabolic risk reduction in a multiracial cohort of adults a 1 year pilot study
topic multidisciplinary
obesity
risk factors
body mass index
cardiometabolic
url https://www.mdpi.com/2072-6643/14/16/3391
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