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Risk assessment, management program decreases all-cause mortality in type 2 diabetes
Among a cohort of adults with type 2 diabetes, those who participated in a risk assessment and management program had lower all-cause mortality, cardiovascular disease/microvascular complications, hospitalizations, emergency attendance and specialist attendance compared with those treated with usual care, study data show.
Esther Yee Tak Yu, MBBS, of the department of family medicine and primary care at Ap Lei Chau Clinic, The University of Hong Kong, and colleagues evaluated data on Chinese adults with type 2 diabetes receiving primary care between August 2009 and June 2011 to determine the 5-year effectiveness of a multidisciplinary Risk Assessment and Management Program for Primary Care Patients with Type 2 Diabetes Mellitus (RAMP-DM; n = 26,718) vs. usual care (n = 26,718). Participants were followed for a median 4.5 years.
The cumulative incidence of diabetes-related complications and all-cause mortality was higher in the usual care group (43.6%) than the RAMP-DM group (23.2%). The RAMP-DM group compared with the usual care group had lower incidence rates for CVD/microvascular complications (4.34 cases per 100 person-years vs. 7.73 cases) and all-cause mortality (1.68 cases per 100 person-years vs. 5.07 cases). Compared with the usual care group, the RAMP-DM group had a 40.6% greater reduction in the risk for CVD/microvascular complications (P < .001) and 66.1% greater reduction in the risk for all-cause mortality (P < .001). Hospitalizations (P < .001), emergency attendance (P < .001) and specialist attendance (P < .001) were lower in the RAMP-DM group than the usual care group.
“Our findings highlight the importance of early optimal [diabetes] control and risk factor management by risk assessment and stratification and multidisciplinary management in order to delay disease progression and prevent the development of complications,” the researchers wrote. “Further studies to evaluate the cost-effectiveness of RAMP-DM from health service provider and societal perspectives should be conducted to confirm whether the RAMP-DM is cost-effective.” – by Amber Cox
Disclosures: The authors report no relevant financial disclosures.