Please select the eligibility criteria that correspond to the clinical trial below.
Title: Improving Adherence to Blood Pressure Guidelines
Brief Summary: The purpose of this study is to evaluate the impact of physician/pharmacist collaborative teams on hypertension guideline adherence for patients with uncontrolled hypertension in six family medicine practice sites in Iowa.


Options:
A: Inclusion Criteria:

* Ages 18-75,
* Type 2 DM,
* Enrolled at community health center,
* Latino ethnicity,
* non Project Dulce participant,
* HbA1c\>/= 8%, must be able to read

Exclusion Criteria:

* Have a severe illness precluding frequent visits to the clinic,
* have a severe medical condition, poor mental function or any other reason to expect patient difficulty in complying with the requirements of the study, any history of malignancy, except subjects who have been disease-free for \>10 years, or whose only malignancy has been basal or squamous cell skin carcinoma,
* patients who have a creatinine level greater than 3.5,
* any history of drug or alcohol abuse within 12 months prior to the study,
* those who are not a permanent resident in the area.
* Patients who are not willing to use a cell phone with texting capability.
B: Inclusion Criteria:

1. Age 35 years and older
2. Confirmed diagnosis of diabetes based on documented evidence from oral glucose tolerance test or two venous fasting blood sugar levels or known diabetes patient on medication or insulin
3. Poor glycemic control (as evidenced by HbA1c \>=8.0%) and one or both of: dyslipidemia \[Low density Lipoprotein (LDL) \>=130 mg/dl\] or systolic hypertension \[Systolic Blood Pressure (SBP) \>=140 mmHg\], irrespective of lipid- or BP-lowering medication use, respectively
4. Receiving diabetes care in the same clinic for at least 3 months OR even earlier if in the investigator's assessment the patient is likely to follow-up regularly as required by the protocol.
5. Willingness to consent to randomization.

Exclusion Criteria:

Individuals will be excluded from participation if any of the following are present during screening:

1. Known type 1 diabetes mellitus
2. Diabetes secondary to chronic pancreatitis
3. Pregnant OR trying to become pregnant OR of child-bearing potential and not actively practicing birth control (including natural methods)
4. Evidence of pre-existing well-controlled blood glucose, blood pressure or LDL-cholesterol (as evidenced by HbA1c \< 7.0%, SBP \< 130 mmHg, LDL-cholesterol \< 100 mg/dl \[LDL-cholesterol \< 70 mg/dl with history of CVD event\]) obtained from screening within a period not exceeding 28 days (4 weeks) prior to randomization
5. Documented cardiovascular event (coronary revascularization, stroke, MI, unstable angina) in past 12 months
6. Current symptomatic Congestive Heart Failure (CHF) or New York Heart Association (NYHA) Class 3 or 4 effort intolerance
7. Documented non-diabetic kidney disease OR pre-existing end -stage renal disease (on renal replacement therapy \[dialysis or transplant\])
8. Transaminase \>3 times upper limit of normal OR active liver disease within past 2 years
9. Malignancy or life-threatening disease with death probable in 4 years
10. Any current medication (e.g. long-term steroids, protease inhibitors) that, in the opinion of the site investigator, would interfere with participant's diabetic status and follow-up
11. Any condition or circumstance that is unrelated to diabetes progression, that in the opinion of the site investigator would interfere with the participant's diabetic status and follow-up: including (but not limited to) other endocrinopathy \[adrenal, pituitary\], Tuberculosis (TB) patient on treatment, psychiatric illness or cognitive impairment, alcohol or drug abuse, history of organ transplant, Body Mass index (BMI) \>= 45 kg/m2
12. On an investigational drug in the last 3 months
13. Currently participating in a clinical trial
14. No fixed address or contact details
15. Plans to move in the next 3 years
16. A member of the participant's household is currently in the trial
17. Inability or unwillingness of individual or legal guardian /representative to give written informed consent
C: Inclusion Criteria:

* Full time family physicians (FP) \>25 hours per week in office
* Ability to generate a listing of patients with type 2 diabetes (T2DM) from their practice or billing records.
* Generation of a practice list of patients with T2DM
* A minimum of 50 patients with type 2 diabetes in their practice.
* Support the generation of a Diabetes Practice Profile prior to the deadline established
* A minimum of 6 insulin-eligible patients
* Attendance at the scheduled Workshop (if unable to attend the Workshop must be available to be educated and trained by diabetes nurse educator(DNE) using a Workshop DVD)

Exclusion Criteria:

* FP does not attend Workshop or complete educational training using Workshop DVD with DNE guidance
* FPs who anticipate retiring within the post-intervention period, moving their practice to another city, or having locum coverage of their practice for more than 4 weeks during the post-intervention period
* FPs currently participating in a diabetes behaviour-change intervention trial
* FPs working in an academic environment
* FPs unlikely to comply with protocol, (uncooperative attitude, unlikelihood of completing the study).
D: Inclusion Criteria for Phase II:

* Poorly controlled blood pressure based on clinic blood pressures
* Males or females, over 21 years of age
* Taking zero to three BP medications with no change in the regimen or dose within the past 4 weeks
* Have established medical care at the Family Medicine Clinic
* Nondiabetic patients with clinic BP values (average of the last three clinic readings during the previous 12 months) of 140 to 179 mm Hg systolic BP or 90 to 109 mm Hg diastolic BP, or diabetic patients with clinic BP values of 130 to 179 systolic or 80 to 109 diastolic

Exclusion Criteria for Phase II:

* Stage 3 hypertension (BPs greater than 180/110 mm Hg), or any evidence of hypertensive urgency or emergency
* Recent myocardial infarction or stroke (within the past 6 months prior to enrollment)
* New York Heart Association Class III or IV congestive heart failure
* Unstable angina
* Serious renal or hepatic disease, including greater than or equal to 1 gram of proteinuria per day
* Pregnancy
* Poor prognosis with a life expectancy estimated at less than 3 years
* Dementia or cognitive impairment

Answer: D