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Article: Effectiveness of a multidisciplinary risk assessment and management programme—diabetes mellitus (RAMP-DM) on patient-reported outcomes

TitleEffectiveness of a multidisciplinary risk assessment and management programme—diabetes mellitus (RAMP-DM) on patient-reported outcomes
Authors
Issue Date2016
Citation
Endocrine, 2016 How to Cite?
AbstractLittle is known about how the patient-reported outcomes is influenced by multidisciplinary-risk-assessment-and-management-programme for patients with diabetes mellitus (RAMP-DM). This paper aims to evaluate the effectiveness of RAMP-DM on patient-reported outcomes. This was a prospective longitudinal study on 1039 diabetes mellitus patients (714/325 RAMP-DM/non-RAMP-DM) managed in primary care setting. 536 and 402 RAMP-DM participants, and 237 and 187 non-RAMP-DM participants were followed up at 12 and 24 months with completed survey, respectively. Patient-reported outcomes included health-related quality of life, change in global health condition and patient enablement measured by Short Form-12 Health Survey version-2 (SF-12v2), Global Rating Scale, Patient Enablement Instrument respectively. The effects of RAMP-DM on patient-reported outcomes were evaluated by mixed effect models. Subgroup analysis was performed by stratifying haemoglobin A1c (HbA1c) (optimal HbA1c < 7 % and suboptimal HbA1c ≥ 7 %). RAMP-DM with suboptimal HbA1c was associated with greater improvement in SF-12v2 physical component summary score at 12-month (coefficient:3.80; P-value < 0.05) and 24-month (coefficient:3.82;P-value < 0.05), more likely to feel more enabled at 12-month (odds ratio: 2.57; P-value < 0.05), and have improved in GRS at 24-month (odds ratio:4.05; P-value < 0.05) compared to non-RAMP-DM participants. However, there was no significant difference in patient-reported outcomes between RAMP-DM and non-RAMP-DM participants with optimal HbA1c. Participation in RAMP-DM is effective in improving physical component of HRQOL, Global Rating Scale and patient enablement among diabetes mellitus patients with suboptimal HbA1c, but not in those with optimal HbA1c. Patients with sub-optimal diabetes mellitus control should be the priority target population for RAMP-DM. This observational study design may have potential bias in the characteristics between groups, and randomized clinical trial is needed to confirm the results.
Persistent Identifierhttp://hdl.handle.net/10722/234689

 

DC FieldValueLanguage
dc.contributor.authorWan, YF-
dc.contributor.authorFung, SCC-
dc.contributor.authorWong, CKH-
dc.contributor.authorChoi, PH-
dc.contributor.authorJIAO, F-
dc.contributor.authorChan, KC-
dc.contributor.authorChan, KH-
dc.contributor.authorLam, CLK-
dc.date.accessioned2016-10-14T13:48:38Z-
dc.date.available2016-10-14T13:48:38Z-
dc.date.issued2016-
dc.identifier.citationEndocrine, 2016-
dc.identifier.urihttp://hdl.handle.net/10722/234689-
dc.description.abstractLittle is known about how the patient-reported outcomes is influenced by multidisciplinary-risk-assessment-and-management-programme for patients with diabetes mellitus (RAMP-DM). This paper aims to evaluate the effectiveness of RAMP-DM on patient-reported outcomes. This was a prospective longitudinal study on 1039 diabetes mellitus patients (714/325 RAMP-DM/non-RAMP-DM) managed in primary care setting. 536 and 402 RAMP-DM participants, and 237 and 187 non-RAMP-DM participants were followed up at 12 and 24 months with completed survey, respectively. Patient-reported outcomes included health-related quality of life, change in global health condition and patient enablement measured by Short Form-12 Health Survey version-2 (SF-12v2), Global Rating Scale, Patient Enablement Instrument respectively. The effects of RAMP-DM on patient-reported outcomes were evaluated by mixed effect models. Subgroup analysis was performed by stratifying haemoglobin A1c (HbA1c) (optimal HbA1c < 7 % and suboptimal HbA1c ≥ 7 %). RAMP-DM with suboptimal HbA1c was associated with greater improvement in SF-12v2 physical component summary score at 12-month (coefficient:3.80; P-value < 0.05) and 24-month (coefficient:3.82;P-value < 0.05), more likely to feel more enabled at 12-month (odds ratio: 2.57; P-value < 0.05), and have improved in GRS at 24-month (odds ratio:4.05; P-value < 0.05) compared to non-RAMP-DM participants. However, there was no significant difference in patient-reported outcomes between RAMP-DM and non-RAMP-DM participants with optimal HbA1c. Participation in RAMP-DM is effective in improving physical component of HRQOL, Global Rating Scale and patient enablement among diabetes mellitus patients with suboptimal HbA1c, but not in those with optimal HbA1c. Patients with sub-optimal diabetes mellitus control should be the priority target population for RAMP-DM. This observational study design may have potential bias in the characteristics between groups, and randomized clinical trial is needed to confirm the results.-
dc.languageeng-
dc.relation.ispartofEndocrine-
dc.titleEffectiveness of a multidisciplinary risk assessment and management programme—diabetes mellitus (RAMP-DM) on patient-reported outcomes-
dc.typeArticle-
dc.identifier.emailWan, YF: yfwan@hku.hk-
dc.identifier.emailFung, SCC: cfsc@hku.hk-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailChoi, PH: h0714919@connect.hku.hk-
dc.identifier.emailChan, KC: kcchanae@hku.hk-
dc.identifier.emailChan, KH: khychan4@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.identifier.doi10.1007/s12020-016-1124-1-
dc.identifier.hkuros270057-

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