چکیده (انگلیسی):

Background:There is some evidence to support a risk-stratified, multi-disciplinary approach to manage patients
with hypertension in primary care. The aim of this study is to evaluate the quality of care (QOC) of a multidisciplinary Risk Assessment and Management Programme for Hypertension (RAMP-HT) for hypertensive patients in
busy government-funded primary care clinics in Hong Kong. The objectives are to develop an evidence-based,
structured and comprehensive evaluation framework on quality of care, to enhance the QOC of the RAMP-HT
through an audit spiral of two evaluation cycles and to determine the effectiveness of the programme in reducing
cardiovascular disease (CVD) risk.
Method/Design:A longitudinal study is conducted using the Action Learning and Audit Spiral methodologies to
measure whether pre-set target standards of care intended by the RAMP-HT are achieved. A structured evaluation
framework on the quality of structure, process and outcomes of care has been developed based on the programme
objectives and literature review in collaboration with the programme workgroup and health service providers. Each
participating clinic is invited to complete a structure of care evaluation questionnaire in each evaluation cycle. The
data of all patients who have enrolled into the RAMP-HT in the pre-defined evaluation periods are used for the
evaluation of the process and outcomes of care in each evaluation cycle. For evaluation of the effectiveness of
RAMP-HT, the primary outcomes including blood pressure (both systolic and diastolic), low-density lipoprotein
cholesterol and estimated 10-year CVD risk of RAMP-HT participants are compared to those of hypertensive patients
in usual care without RAMP-HT.
Discussion:The QOC and effectiveness of the RAMP-HT in improving clinical and patient-reported outcomes for
patients with hypertension in normal primary care will be determined. Possible areas for quality enhancement and
standards of good practice will be established to inform service planning and policy decision making.