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Conference Paper: Clinical Benefits of the Multi-disciplinary Risk Assessment and Management Programme-Hypertension (RAMP-HT) for Patients with Hypertension in GOPCs - the First Year Experience

TitleClinical Benefits of the Multi-disciplinary Risk Assessment and Management Programme-Hypertension (RAMP-HT) for Patients with Hypertension in GOPCs - the First Year Experience
Authors
Issue Date2014
PublisherThe Hong Kong College of Family Physicians. The Program and Abstract Book's website is located at: http://www.hkcfp.org.hk/images/stories/documents/HKPCC_2014/HKPCC%202014%20Program%20Book.pdf
Citation
The 4th Hong Kong Primary Care Conference (HKPCC 2014) and 4-Party General Practice/Family Medicine Conference, Hong Kong, China, 6-9 June 2014. In Program and Abstract Book, 2014, p. 80 How to Cite?
AbstractIntroduction: Since October 2011, the Hospital Authority (HA) has introduced the Risk Assessment and Management Programme (RAMP) for patients with hypertension (HT) managed in the public primary care setting. The programme aimed to improve cardiovascular outcomes for hypertensive patients through risk assessment, risk stratification and risk-guided management by a multi-disciplinary effort. This study evaluated the clinical benefits of RAMP-HT at 12-month. Method: Evaluation involved 5 clusters under HA that had launched RAMP-HT since Oct 2011. A sampling of 13,155 hypertensive patients aged ≤80, without existing cardiovascular diseases and with suboptimal blood pressure (i.e. systolic blood pressure (SBP) >140mmHg or diastolic blood pressure (DBP) >90mmHg) who were enrolled into RAMP-HT for more than one year was compared to 33,172 non-RAMP-HT participants on clinical outcomes including SBP, low-density lipoprotein cholesterol (LDL-C) and the estimated 10-year cardiovascular disease (CVD) risk using Framingham risk scores equation to reveal the net benefit of RAMP-HT. Multivariate linear regressions were used to identify the net effectiveness of RAMP-HT by adjusting the potential confounding variables. Results: There was a reduction in mean SBP, LDL-C and estimated 10-year cardiovascular risk in both the RAMP-HT participants and hypertensive patients receiving usual care from general-out-patient-clinics (GOPCs) at 12 months. The RAMP-HT participants had greater reduction in LDL-C (coef. = -0.02, P-value = 0.04) and estimated 10-years CVD risk (coef. = -0.45, P-value < 0.01) compared to the usual care group, and the difference was statistically significant. RAMP-HT participants also had a greater reduction in SBP than the usual care group, however the difference did not reach statistical significance. Discussion: For hypertensive patients aged ≤80 with suboptimal blood pressure control but without existing cardiovascular complications, the multi-disciplinary RAMP-HT was shown to confer additional clinical benefits over usual care at GOPCs in terms of a greater reduction of estimated 10-year CVD risk and LDL-C at 12 months. A more comprehensive and longer-term evaluation of the effectiveness of RAMP-HT should be performed to better illustrate the true clinical impact of such programme.
DescriptionConference Theme: With the Patients, For the Patients: Achieving Health Equity in Primary Care
Oral Presentation 1.5
Persistent Identifierhttp://hdl.handle.net/10722/202076

 

DC FieldValueLanguage
dc.contributor.authorYu, YTEen_US
dc.contributor.authorWan, YFen_US
dc.contributor.authorChan, KCen_US
dc.contributor.authorChan, KHen_US
dc.contributor.authorDai, Den_US
dc.contributor.authorKwok, RLPen_US
dc.contributor.authorFong, DYTen_US
dc.contributor.authorLam, CLKen_US
dc.date.accessioned2014-08-21T08:02:35Z-
dc.date.available2014-08-21T08:02:35Z-
dc.date.issued2014en_US
dc.identifier.citationThe 4th Hong Kong Primary Care Conference (HKPCC 2014) and 4-Party General Practice/Family Medicine Conference, Hong Kong, China, 6-9 June 2014. In Program and Abstract Book, 2014, p. 80en_US
dc.identifier.urihttp://hdl.handle.net/10722/202076-
dc.descriptionConference Theme: With the Patients, For the Patients: Achieving Health Equity in Primary Care-
dc.descriptionOral Presentation 1.5-
dc.description.abstractIntroduction: Since October 2011, the Hospital Authority (HA) has introduced the Risk Assessment and Management Programme (RAMP) for patients with hypertension (HT) managed in the public primary care setting. The programme aimed to improve cardiovascular outcomes for hypertensive patients through risk assessment, risk stratification and risk-guided management by a multi-disciplinary effort. This study evaluated the clinical benefits of RAMP-HT at 12-month. Method: Evaluation involved 5 clusters under HA that had launched RAMP-HT since Oct 2011. A sampling of 13,155 hypertensive patients aged ≤80, without existing cardiovascular diseases and with suboptimal blood pressure (i.e. systolic blood pressure (SBP) >140mmHg or diastolic blood pressure (DBP) >90mmHg) who were enrolled into RAMP-HT for more than one year was compared to 33,172 non-RAMP-HT participants on clinical outcomes including SBP, low-density lipoprotein cholesterol (LDL-C) and the estimated 10-year cardiovascular disease (CVD) risk using Framingham risk scores equation to reveal the net benefit of RAMP-HT. Multivariate linear regressions were used to identify the net effectiveness of RAMP-HT by adjusting the potential confounding variables. Results: There was a reduction in mean SBP, LDL-C and estimated 10-year cardiovascular risk in both the RAMP-HT participants and hypertensive patients receiving usual care from general-out-patient-clinics (GOPCs) at 12 months. The RAMP-HT participants had greater reduction in LDL-C (coef. = -0.02, P-value = 0.04) and estimated 10-years CVD risk (coef. = -0.45, P-value < 0.01) compared to the usual care group, and the difference was statistically significant. RAMP-HT participants also had a greater reduction in SBP than the usual care group, however the difference did not reach statistical significance. Discussion: For hypertensive patients aged ≤80 with suboptimal blood pressure control but without existing cardiovascular complications, the multi-disciplinary RAMP-HT was shown to confer additional clinical benefits over usual care at GOPCs in terms of a greater reduction of estimated 10-year CVD risk and LDL-C at 12 months. A more comprehensive and longer-term evaluation of the effectiveness of RAMP-HT should be performed to better illustrate the true clinical impact of such programme.en_US
dc.languageengen_US
dc.publisherThe Hong Kong College of Family Physicians. The Program and Abstract Book's website is located at: http://www.hkcfp.org.hk/images/stories/documents/HKPCC_2014/HKPCC%202014%20Program%20Book.pdfen_US
dc.relation.ispartofHong Kong Primary Care Conference, HKPCC 2014 & 4-Party General Practice/Family Medicine Conferenceen_US
dc.titleClinical Benefits of the Multi-disciplinary Risk Assessment and Management Programme-Hypertension (RAMP-HT) for Patients with Hypertension in GOPCs - the First Year Experienceen_US
dc.typeConference_Paperen_US
dc.identifier.emailYu, YTE: ytyu@hku.hken_US
dc.identifier.emailWan, YF: yfwan@hku.hken_US
dc.identifier.emailChan, KC: kcchanae@hku.hken_US
dc.identifier.emailChan, KH: khychan4@hku.hken_US
dc.identifier.emailFong, DYT: dytfong@hku.hken_US
dc.identifier.emailLam, CLK: clklam@hku.hken_US
dc.identifier.authorityYu, YTE=rp01693en_US
dc.identifier.authorityFong, DYT=rp00253en_US
dc.identifier.authorityLam, CLK=rp00350en_US
dc.identifier.hkuros234393en_US
dc.identifier.spage80en_US
dc.identifier.epage80en_US
dc.publisher.placeHong Kongen_US

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