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

Cardiovascular Diabetology

Volumn 13, Issue 1, 2014, Pages

  Jiao, Fang Fang ^a   Fung, Colman Siu Cheung ^a   Wong, Carlos King Ho ^a   Wan, Yuk Fai ^a   Dai, Daisy ^b   Kwok, Ruby ^b   Lam, Cindy Lo Kuen ^a  

^a UNIVERSITY OF HONG KONG   (Hong Kong)

^b HOSPITAL AUTHORITY   (Hong Kong)

Author keywords

Diabetes; Effectiveness; Multidisciplinary intervention; RAMP DM; Risk stratification

Indexed keywords

HEMOGLOBIN A1C;

ADULT; AGED; ARTICLE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CEREBROVASCULAR ACCIDENT; CHINESE; COMPARATIVE STUDY; CONFOUNDING VARIABLE; CONTROLLED STUDY; DIABETES MELLITUS; DIASTOLIC BLOOD PRESSURE; FEMALE; HUMAN; INCIDENCE; ISCHEMIC HEART DISEASE; LONGITUDINAL STUDY; MAJOR CLINICAL STUDY; MALE; PRIMARY MEDICAL CARE; RANDOM SAMPLE; RISK ASSESSMENT; SYSTOLIC BLOOD PRESSURE; CARDIOVASCULAR DISEASES; DIABETES MELLITUS, TYPE 2; DISEASE MANAGEMENT; FOLLOW UP; MIDDLE AGED; PATIENT CARE; PRIMARY HEALTH CARE; RANDOMIZED CONTROLLED TRIAL; RISK FACTOR; TREATMENT OUTCOME; TRENDS;

AGED; CARDIOVASCULAR DISEASES; DIABETES MELLITUS, TYPE 2; DISEASE MANAGEMENT; FEMALE; FOLLOW-UP STUDIES; HUMANS; LONGITUDINAL STUDIES; MALE; MIDDLE AGED; PATIENT CARE TEAM; PRIMARY HEALTH CARE; RISK ASSESSMENT; RISK FACTORS; TREATMENT OUTCOME;

EID: 84921359093     PISSN: None     EISSN: 14752840     Source Type: Journal    
DOI: 10.1186/s12933-014-0127-6     Document Type: Article

References (39)

1. Diabetes atlas, 5rd ed. [ http://www.idf.org/diabetesatlas/ ]
2. Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, Shaw J: Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 2014, 103(2):137-149.
3. Kumar P, Clark M: Diabetes mellitus and other disorders of metabolism. Clin Med 2002, 2:1069-1071.
4. Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, Connolly V, King H: The Burden of Mortality Attributable to Diabetes Realistic estimates for the year 2000. Diabetes Care 2005, 28(9):2130-2135.
5. American Diabetes Association: Standards of medical care in diabetes 2013. Diabetes Care 2013, 36(Supplement 1):S11-S57.
6. Handelsman Y, Mechanick JI, Blonde L, Grunberger G, Bloomgarden ZT, Bray GA, Dagogo-Jack S, Davidson JA, Einhorn D, Ganda O: American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan. Endocr Pract 2011, 17:1-53.
7. National Collaborating Centre for Chronic Conditions: Type 2 Diabetes National Clinical Guideline for Management in Primary and Secondary Care (Update). In Royal College of Physicians. ; 2008.
8. Canadian Diabetes Association: 2008 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes 2008, 32(supplement 1):S1-S201.
9. Esposito K, Gentile S, Candido R, De Micheli A, Gallo M, Medea G, Ceriello A: Management of hyperglycemia in type 2 diabetes: evidence and uncertainty. Cardiovasc Diabetol 2013, 12(1):81.
10. Bodenheimer T, Wagner EH, Grumbach K: Improving primary care for patients with chronic illness. JAMA 2002, 288(14):1775-1779.
11. Bodenheimer T, Wagner EH, Grumbach K: Improving primary care for patients with chronic illness, The Chronic Care Model, Part 2. JAMA 2002, 288(15):1909-1914.
12. Clark CM, Snyder JW, Meek RL, Stutz LM, Parkin CG: A systematic approach to risk stratification and intervention within a managed care environment improves diabetes outcomes and patient satisfaction. Diabetes Care 2001, 24(6):1079-1086.
13. Chan J, So W, Ko G, Tong P, Yang X, Ma R, Kong A, Wong R, Le Coguiec F, Tamesis B: The Joint Asia Diabetes Evaluation (JADE) Program: a web based program to translate evidence to clinical practice in Type 2 diabetes. Diabet Med 2009, 26(7):693-699.
14. So WY, Raboca J, Sobrepena L, Yoon KH, Deerochanawong C, Ho LT, Himathongkam T, Tong P, Lyubomirsky G, Ko G: Comprehensive risk assessments of diabetic patients from seven Asian countries: the Joint Asia Diabetes Evaluation (JADE) program. J Diabetes 2011, 3(2):109-118.
15. Harris M, Greaves F, Patterson S, Jones J, Pappas Y, Majeed A, Car J: The North West London Integrated Care Pilot: innovative strategies to improve care coordination for older adults and people with diabetes. J Ambul Care Manage 2012, 35(3):216-225.
16. Greaves F, Pappas Y, Bardsley M, Harris M, Curry N, Holder H, Blunt I, Soljak M, Gunn L, Majeed A: Evaluation of complex integrated care programmes: the approach in North West London. Int J Integr Care 2013, Jan-Mar, URN:NBN:NL:UI:10-1-114283. [ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653284/ ]
17. Fung CS, Chin WY, Dai DS, Kwok RL, Tsui EL, Wan YF, Wong W, Wong C, Fong DY, Lam CL: Evaluation of the quality of care of a multi-disciplinary risk factor assessment and management programme (RAMP) for diabetic patients. BMC Fam Pract 2012, 13:116 [ http://www.biomedcentral.com/1471-2296/13/116 ]
18. Food and Health Bureau: Hong Kong Reference Framework for Diabetes Care for Adults in Primary Care Settings. 2010.
19. D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB: General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008, 117(6):743-753.
20. Stevens RJ, Kothari V, Adler AI, Stratton IM: The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56). Clin Sci (Lond) 2001, 101(6):671-679.
21. Kothari V, Stevens RJ, Adler AI, Stratton IM, Manley SE, Neil HA, Holman RR: UKPDS 60 risk of stroke in type 2 diabetes estimated by the UK Prospective Diabetes Study risk engine. Stroke 2002, 33(7):1776-1781.
22. Rückert I-M, Maier W, Mielck A, Schipf S, Völzke H, Kluttig A, Greiser K-H, Berger K, Müller G, Ellert U: Personal attributes that influence the adequate management of hypertension and dyslipidemia in patients with type 2 diabetes. Results from the DIAB-CORE Cooperation. Cardiovasc Diabetol 2012, 11(1):120.
23. Moe B, Augestad LB, Nilsen TI: Diabetes severity and the role of leisure time physical exercise on cardiovascular mortality: the Nord-Trøndelag Health study (HUNT), Norway. Cardiovasc Diabetol 2013, 12(1):83.
24. Zhao W, Katzmarzyk PT, Horswell R, Wang Y, Johnson J, Hu G: HbA1c and coronary heart disease risk among diabetic patients. Diabetes Care 2014, 37(2):428-435.
25. Jiao FF, Lam CLK, Fung C, McGhee SM: Comparison of four cardiovascular risk prediction functions among Chinese patients with diabetes mellitus in the primary care setting. [ http://onlinelibrary.wiley.com/doi/10.1111/jdi.12188/abstract ]
26. Yang X, So W-Y, Kong AP, Ma RC, Ko GT, Ho C-S, Lam CW, Cockram CS, Chan JC, Tong PC: Development and validation of a total coronary heart disease risk score in type 2 diabetes mellitus. Am J Cardiol 2008, 101(5):596-601.
27. New Zealand Primary Care Handbook. In 2012 [ http://www.health.govt.nz/publication/new-zealand-primary-care-handbook-2012 ]
28. Blackberry ID, Furler JS, Best JD, Chondros P, Vale M, Walker C, Dunning T, Segal L, Dunbar J, Audehm R: Effectiveness of general practice based, practice nurse led telephone coaching on glycaemic control of type 2 diabetes: the Patient Engagement And Coaching for Health (PEACH) pragmatic cluster randomised controlled trial. BMJ 2013, 347:f5272 [ http://dx.doi.org/10.1136/bmj.f5272 ]
29. Cárdenas-Valladolid J, Salinero-Fort MA, Gómez-Campelo P, De Burgos-Lunar C, Abánades-Herranz JC, Arnal-Selfa R, López-Andrés A: Effectiveness of standardized Nursing Care Plans in health outcomes in patients with type 2 Diabetes Mellitus: a two-year prospective follow-up study. PLoS One 2012, 7(8):e43870.
30. Gabbay RA, Lendel I, Saleem TM, Shaeffer G, Adelman AM, Mauger DT, Collins M, Polomano RC: Nurse case management improves blood pressure, emotional distress and diabetes complication screening. Diabetes Res Clin Pract 2006, 71(1):28-35.
31. Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL: Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care 2011, 34(9):1934-1942.
32. Maislos M, Weisman D: Multidisciplinary approach to patients with poorly controlled type 2 diabetes mellitus: a prospective, randomized study. Acta Diabetol 2004, 41(2):44-48.
33. Chen MY, Huang WC, Peng YS, Guo JS, Chen CP, Jong MC, Lin HC: Effectiveness of a health promotion programme for farmers and fishermen with type 2 diabetes in Taiwan. J Adv Nurs 2011, 67(9):2060-2067.
34. Litaker D, MION LC, Planavsky L, Kippes C, Mehta N, Frolkis J: Physician-nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care. J Interprof Care 2003, 17(3):223-237.
35. Mousquès J, Bourgueil Y, Le Fur P, Yilmaz E: Effect of a French experiment of team work between general practitioners and nurses on efficacy and cost of type 2 diabetes patients care. Health Policy 2010, 98(2):131-143.
36. Kent D, D'Eramo Melkus G, Stuart PMW, McKoy JM, Urbanski P, Boren SA, Coke L, Winters JE, Horsley NL, Sherr D: Reducing the risks of diabetes complications through diabetes self-management education and support. Popul Health Manag 2013, 16(2):74-81.
37. Wong CK, Wong WC, Lam CL, Wan Y, Wong WH, Chung K, Dai D, Tsui EL, Fong DY: Effects of Patient Empowerment Programme (PEP) on clinical outcomes and health service utilization in type 2 diabetes mellitus in primary care: an observational matched cohort study. PLoS One 2014, 9(5):e95328.
38. Debussche X, Collin F, Fianu A, Balcou-Debussche M, Fouet-Rosiers I, Koleck M, Favier F: Structured self-management education maintained over two years in insufficiently controlled type 2 diabetes patients: the ERMIES randomised trial in Reunion Island. Cardiovasc Diabetol 2012, 11:91.
39. Linmans JJ, Viechtbauer W, Koppenaal T, Spigt M, Knottnerus JA: Using electronic medical records analysis to investigate the effectiveness of lifestyle programs in real-world primary care is challenging: a case study in diabetes mellitus. J Clin Epidemiol 2012, 65(7):785-792.