title: Evaluation of the quality of care of a multi-disciplinary Risk Factor Assessment and Management Programme for Hypertension (RAMP-HT).
abstract: 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 multi-disciplinary 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong. ytyu@hku.hk.
authors.forename: Esther Yee Tak
authors.initials: EY
authors.lastname: Yu
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong. yfwan@hku.hk.
authors.forename: Eric Yuk Fai
authors.initials: EY
authors.lastname: Wan
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong. khychan4@hku.hk.
authors.forename: Karina Hiu Yen
authors.initials: KH
authors.lastname: Chan
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong. carlosho@hku.hk.
authors.forename: Carlos King Ho
authors.initials: CK
authors.lastname: Wong
authors.affiliation: Primary and Community Services Department, Hospital Authority Head Office, Hong Kong Hospital Authority, Kowloon, Hong Kong. kwoklp@ha.org.hk.
authors.forename: Ruby Lai Ping
authors.initials: RL
authors.lastname: Kwok
authors.affiliation: School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong. dytfong@hku.hk.
authors.forename: Daniel Yee Tak
authors.initials: DY
authors.lastname: Fong
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong. clklam@hku.hk.
authors.forename: Cindy Lo Kuen
authors.initials: CL
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010346:Patient Care Management / Q000379:methods / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration*; D057240:Patient Preference / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D015397:Program Evaluation; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires