Authors (including presenting author) :
Jiao FF(1), Chiang LK(1), Li YC(1), Chen CXR (1)
Affiliation :
(1)Department of Family Medicine and Primary Healthcare, Kowloon Central Cluster, Hospital Authority, Queen Elizabeth Hospital
Keyword 1: :
Diabetes mellitus
Keyword 3: :
Primary care
Introduction :
In Hong Kong, approximately one in ten adults lives with DM, and 19.0% of individuals aged 65-84 were diagnosed with DM in 2022. The Hospital Authority (HA) catered to over 540 000 people with diabetes in 2022, with an annual growth rate at 4 to 5 percent. Two-thirds of these patients were managed under public primary care. HA initiated the Risk Assessment and Management Program in Diabetes (RAMP-DM) in August 2009. This program aimed to enhance the DM care in the primary care setting. Currently, there is a lack of data on the latest clinical profiles, treatment modality and complication status of people with diabetes under public primary care in Hong Kong. As we mark the 10-year milestone of RAMP-DM’s implementation, an updated comparison of DM care between the pre-RAMP-DM and RAMP-DM era is crucial for further enhancing diabetic care in HA.
Objectives :
The objectives of this study is to evaluate the changes in clinical profiles, complications, and treatment modalities of people with diabetes after a decade of implementing the multidisciplinary Risk Assessment and Management Program in DM (RAMP-DM).
Methodology :
A two-phase cross-sectional study was conducted to examine the evolution of care for people with diabetes in 13 public primary care clinics from 1 August 2008 to 31 July 2009 and 1 August 2019 to 31 July 2020.
Result & Outcome :
The average systolic blood pressure (SBP) improved from 131.66±16.89 to 126.88±12.54 mmHg (P< 0.001). Hemoglobin A1c (HbA1c) and low-density lipoprotein concentration (LDL-C) improved from 7.47±1.4 to 6.88±1.00% (P< 0.001) and 3.09±0.85 to 2.01±0.68 mmol/L (P< 0.001), respectively. However, the percentage of patients with ischemic heart disease (IHD) rose from 7.73% to 10.47% (P< 0.001), and stroke increased from 8.22% to 12.44% (P< 0.001) over the decade. This is the first study to demonstrate the improvement of clinical parameters and treatment modalities of diabetes care in a public primary care setting over a decade. The increasing prevalence of IHD and stroke may be related to the aging population and the decreasing trend of all-cause mortality among people with diabetes.
