Evaluation of hypertension-related complications 10 years after implementation of risk assessment and management programme for hypertension: a target trial emulation - Scorecard - MDSpire
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Evaluation of hypertension-related complications 10 years after implementation of risk assessment and management programme for hypertension: a target trial emulation
Clinical Scorecard: Long-term Assessment of Hypertension-Related Complications Following a Decade of a Risk Assessment and Management Program: Insights from a Target Trial Emulation
At a Glance
Category
Detail
Condition
Hypertension (HT)
Key Mechanisms
Risk-stratified, multidisciplinary management including CVD risk assessment by trained nurses and tailored follow-up care supplementing usual primary care
Target Population
Patients with hypertension without prior diabetes mellitus, end-stage renal disease, peripheral vascular disease, cardiovascular disease, or specialist outpatient attendance
Care Setting
Public general outpatient clinics (GOPCs) in Hong Kong primary care system
Key Highlights
RAMP-HT participants had a 9% reduced risk of cardiovascular diseases compared to usual care over 10 years.
RAMP-HT participants had a 12% reduced risk of all-cause mortality compared to usual care over 10 years.
The program integrates multidisciplinary interventions and risk stratification to enhance usual hypertension care in primary care.
Guideline-Based Recommendations
Diagnosis
Use trained nurses to perform cardiovascular disease risk assessments in hypertensive patients.
Management
Implement a protocol-driven, risk-stratified, multidisciplinary program supplementing usual care for hypertension management.
Provide risk-stratified follow-up care by nurses and allied health professionals based on individual CVD risk.
Monitoring & Follow-up
Long-term monitoring of cardiovascular outcomes and all-cause mortality to assess program effectiveness.
Risks
Consider potential biases in observational studies; target trial emulation can help mitigate immortal time and selection biases.
Patient & Prescribing Data
337,990 hypertensive patients without prior major comorbidities receiving care in primary care clinics.
Supplementing usual care with RAMP-HT multidisciplinary interventions is associated with significant reductions in cardiovascular events and mortality over 10 years.
Clinical Best Practices
Incorporate multidisciplinary teams including nurses and allied health professionals in hypertension management.
Use risk stratification to tailor follow-up intensity and interventions for hypertensive patients.
Integrate structured risk assessment protocols into routine primary care to improve long-term outcomes.
Leverage electronic health records for large-scale monitoring and evaluation of hypertension management programs.
by Zoey Cho Ting Wong, Ivy Lynn Mak, Esther Yee Tak Yu, Emily Tsui Yee Tse, Julie Yun Chen, Weng Yee Chin, David Vai Kiong Chao, Wendy Wing Sze Tsui, Tony King Hang Ha, Eric Yuk Fai Wan, Cindy Lo Kuen Lam
