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The Impact of Lifedoc Health’s Multidisciplinary Team Approach on Cardiometabolic Risk Profile in a Multiracial Cohort of Adults with Obesity: A 1-year Exploratory Pilot Study
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  • Pedro A Velasquez-Mieyer,
  • Ramfis Nieto-Martinez,
  • Andres Velasquez,
  • Claudia P. Neira,
  • Xichen Mou,
  • Andres Neira,
  • Gabriela Garcia,
  • Pedro A. Velasquez Rodriguez,
  • Marian Levy
Pedro A Velasquez-Mieyer
Lifedoc Health
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Ramfis Nieto-Martinez
Lifedoc Health
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Andres Velasquez
LifeDOC Research
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Claudia P. Neira
Lifedoc Health
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Xichen Mou
The University of Memphis School of Public Health
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Andres Neira
Lifedoc Health
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Gabriela Garcia
Lifedoc Health
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Pedro A. Velasquez Rodriguez
Lifedoc Health
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Marian Levy
The University of Memphis School of Public Health
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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.

Peer review status:IN REVISION

30 Jul 2021Submitted to International Journal of Clinical Practice
31 Jul 2021Assigned to Editor
31 Jul 2021Submission Checks Completed
21 Aug 2021Reviewer(s) Assigned
04 Sep 2021Review(s) Completed, Editorial Evaluation Pending
10 Sep 2021Editorial Decision: Revise Major