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Table 4.7
Comparison of RAMP-DM care and usual care protocols

RAMP-DM care Usual care
Nurses are engaged as RAMP-DM care Managed by GOPC doctors based on the
managers and provide: Hong Kong reference framework for DM care
in primary care which includes:
• Review of screening results • Lifestyle modification (e.g., diet, exercise,
• Individualised DM education
Management • Lifestyle advice (e.g., exercise, diet, smoking • Glucose control and monitoring
smoking cessation)
and drinking)
• Drug treatment (if HbA1c ≥ 7% after
[1]
• Explanation of the cardiovascular risk level
lifestyle modification)
The patient’s disease profile is recorded and • Routine follow-up visits every three months
available to a multi-disciplinary healthcare
team including doctors, nurses, and other
allied health professionals
Initial risk assessment to stratify participants No performance of any risk assessment and
into different disease severity level groups: stratification such as RAMP-DM care; however,
patients have access to:
• Physical examination • Additional assessments and referrals to
Key feature • Laboratory testing allied health professionals (if necessary, at
• Eye and foot assessment
doctor’s discretion):
• Drug adherence
• Lifestyle assessment • Physical examination
• Laboratory testing
• Diabetic complications • Other allied health services
Note: [1] HbA1c (glycated haemoglobin) is a blood test used to monitor blood sugar levels
Sources: Fung et al., 2012; Wan et al., 2018; FHB, 2018

Since its inception, RAMP-DM has undergone multiple evaluations of its efforts. Amongst the
leading papers published on RAMP-DM care, two of the latest studies (2018) have reviewed
the clinical and cost-effectiveness of the two treatment and management protocols, namely
“RAMP care” versus “usual care”. The studies have shown high clinical effectiveness
and cost-effectiveness of the multidisciplinary RAMP-DM for primary care
patients with Type 2 DM compared to usual primary care over a period of five years
(Jiao et al., 2018; Wan et al., 2018).

In the study on clinical effectiveness, researchers found that RAMP-DM care resulted in an
overall reduction of disease complications related to DM from 43.6% (usual care group) to
23.2% (Wan et al., 2018). The findings are consistent with previous studies that observed a
reduction in DM-related complications such as cardiovascular complications (6.69% in the
usual care group to 4.39% in the RAMP-DM group), heart failure (1.37% to 0.79%), and all-
cause mortality (6.07% to 2.22%) over a median follow-up period of 36 months between
control group and RAMP-DM patients (Jiao et al., 2015).

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