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Article: Effects of the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) on biomedical outcomes, observed cardiovascular events and cardiovascular risks in primary care: a longitudinal comparative study

TitleEffects of the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) on biomedical outcomes, observed cardiovascular events and cardiovascular risks in primary care: a longitudinal comparative study
Authors
Issue Date2014
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.cardiab.com/
Citation
Cardiovascular Diabetology, 2014, v. 13 n. 1, p. Article no. 127 How to Cite?
AbstractBackground To assess whether the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) led to improvements in biomedical outcomes, observed cardiovascular events and predicted cardiovascular risks after 12-month intervention in the primary care setting. Methods A random sample of 1,248 people with diabetes enrolled to RAMP-DM for at least 12-months was selected and 1,248 people with diabetes under the usual primary care were matched by age, sex, and HbA1c level at baseline as the usual care group. Biomedical and cardiovascular outcomes were measured at baseline and at 12-month after the enrollment. Difference-in-differences approach was employed to measure the effect of RAMP-DM on the changes in biomedical outcomes, proportion of subjects reaching treatment targets, observed and predicted cardiovascular risks. Results Compared to the usual care group, RAMP-DM group had lower cardiovascular events incidence (1.21% vs 2.89%, P=0.003), and net decrease in HbA1c (-0.20%, P<0.01), SBP (-3.62 mmHg, P<0.01) and 10-year cardiovascular disease (CVD) risks (total CVD risk, -2.06%, P<0.01; coronary heart disease (CHD) risk, -1.43%, P<0.01; stroke risk, ?0.71%, P<0.01). The RAMP-DM subjects witnessed significant rises in the proportion of reaching treatment targets of HbA1c, and SBP/DBP. After adjusting for confounding variables, the significance remained for HbA1c, predicted CHD and stroke risks. Conclusions The RAMP-DM resulted in greater improvements in HbA1c and reduction in observed and predicted cardiovascular risks at 12-months follow-up, which indicated a risk-stratification multidisciplinary intervention was an effective strategy for managing Chinese people with diabetes in the primary care setting. Trial registryClinicalTrials.gov, NCT02034695
Persistent Identifierhttp://hdl.handle.net/10722/203048
ISSN
2015 Impact Factor: 4.534
2015 SCImago Journal Rankings: 1.757
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorJIAO, F-
dc.contributor.authorFung, SCC-
dc.contributor.authorWong, CKH-
dc.contributor.authorWan, YF-
dc.contributor.authorDai, D-
dc.contributor.authorKwok, RLP-
dc.contributor.authorLam, CLK-
dc.date.accessioned2014-09-19T11:22:29Z-
dc.date.available2014-09-19T11:22:29Z-
dc.date.issued2014-
dc.identifier.citationCardiovascular Diabetology, 2014, v. 13 n. 1, p. Article no. 127-
dc.identifier.issn1475-2840-
dc.identifier.urihttp://hdl.handle.net/10722/203048-
dc.description.abstractBackground To assess whether the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) led to improvements in biomedical outcomes, observed cardiovascular events and predicted cardiovascular risks after 12-month intervention in the primary care setting. Methods A random sample of 1,248 people with diabetes enrolled to RAMP-DM for at least 12-months was selected and 1,248 people with diabetes under the usual primary care were matched by age, sex, and HbA1c level at baseline as the usual care group. Biomedical and cardiovascular outcomes were measured at baseline and at 12-month after the enrollment. Difference-in-differences approach was employed to measure the effect of RAMP-DM on the changes in biomedical outcomes, proportion of subjects reaching treatment targets, observed and predicted cardiovascular risks. Results Compared to the usual care group, RAMP-DM group had lower cardiovascular events incidence (1.21% vs 2.89%, P=0.003), and net decrease in HbA1c (-0.20%, P<0.01), SBP (-3.62 mmHg, P<0.01) and 10-year cardiovascular disease (CVD) risks (total CVD risk, -2.06%, P<0.01; coronary heart disease (CHD) risk, -1.43%, P<0.01; stroke risk, ?0.71%, P<0.01). The RAMP-DM subjects witnessed significant rises in the proportion of reaching treatment targets of HbA1c, and SBP/DBP. After adjusting for confounding variables, the significance remained for HbA1c, predicted CHD and stroke risks. Conclusions The RAMP-DM resulted in greater improvements in HbA1c and reduction in observed and predicted cardiovascular risks at 12-months follow-up, which indicated a risk-stratification multidisciplinary intervention was an effective strategy for managing Chinese people with diabetes in the primary care setting. Trial registryClinicalTrials.gov, NCT02034695-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.cardiab.com/-
dc.relation.ispartofCardiovascular Diabetology-
dc.rightsCardiovascular Diabetology. Copyright © BioMed Central Ltd.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleEffects of the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) on biomedical outcomes, observed cardiovascular events and cardiovascular risks in primary care: a longitudinal comparative study-
dc.typeArticle-
dc.identifier.emailFung, SCC: cfsc@hku.hk-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailWan, YF: yfwan@hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityFung, SCC=rp01330-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityLam, CLK=rp00350-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12933-014-0127-6-
dc.identifier.pmid25142791-
dc.identifier.pmcidPMC4145236-
dc.identifier.scopuseid_2-s2.0-84921359093-
dc.identifier.hkuros236741-
dc.identifier.volume13-
dc.identifier.issue1-
dc.identifier.spageArticle no. 127-
dc.identifier.epageArticle no. 127-
dc.identifier.isiWOS:000345359500001-
dc.publisher.placeUnited Kingdom-

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