title: Use of a multidisciplinary tool to achieve target outcomes in Native American patients with diabetes: Treat-to-target.
abstract: OBJECTIVE
  Our purpose was to test a communication tool used in a multidisciplinary setting to more effectively achieve the recommended goals for glucose, blood pressure, lipids, and prophylactic aspirin use in a Native American population with type 2 diabetes.
  
  
  METHODS
  One hundred randomly selected patients were included in this observational, pre-intervention, post-intervention study design. The team began with a chart audit documenting hemoglobin A(1c) (Hgb A(1c)), blood pressure, cholesterol levels, and aspirin use. The intervention included the development of a one page form used to prompt providers to intensify therapy when the patient was not meeting evidence-based goals. The audit was repeated one year later.
  
  
  RESULTS
  Analysis of 74 patients completing the study showed a decrease in Hgb A1C from 8.812% pre-intervention to a mean 8.214% post-intervention (p < 0.007). At the time of pre-intervention audit, patients were already at target for blood pressure and no significant further decrease was found. Measures of total cholesterol, triglycerides, and aspirin use showed improvement, but statistical significance was not met.
  
  
  CONCLUSIONS
  The one-page multidisciplinary tool used to intensify therapy significantly improved glucose control. More consistent interaction of the multidisciplinary team is necessary to reach other desired goals.
authors.affiliation: Creighton University School of Pharmacy and Health Professions, Omaha, NE, USA.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Sexson
authors.forename: Michael S
authors.initials: MS
authors.lastname: Monaghan
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Lenz
authors.forename: Ann Ryan
authors.initials: AR
authors.lastname: Haddad
authors.forename: Gail
authors.initials: G
authors.lastname: Jensen
authors.forename: Gary
authors.initials: G
authors.lastname: Elsasser