Comprehensive risk assessments of diabetic patients from seven Asian countries: The Joint Asia Diabetes Evaluation (JADE) program*

So, Wing‐Yee; Raboca, Josephine; Sobrepeña, Leorino; Yoon, Kun‐Ho; Deerochanawong, Chaicharn; Ho, ­Low‐Tone; Himathongkam, Thep; Tong, Peter C.Y.; Lyubomirsky, Greg; Ko, Gary T.C.; Nan, Hairong; Chan, Juliana C.N.

doi:10.1111/j.1753-0407.2011.00115.x

Cited by 50 publications

(53 citation statements)

References 22 publications

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“…In brief, all the enrolled participants would undergo an intake assessment, which was a comprehensive risk assessment including measurement of risk factors for cardiovascular and renal complications and eye and foot assessment. The case manager, an advanced practice nurse, would review the examinations results, assess the cardiovascular risks, and stratify participants into risk groups ("very high," "high," "medium," and "low") according to the modified Joint Asia Diabetes Evaluation cardiovascular risk stratification flowchart (20). The participants were then assigned to receive appropriate interventions and education provided by a team of multidisciplinary health care professionals, including Associate Consultants in family medicine (AC intervention), registered nurses, advanced practice nurses (nurse intervention), and allied health professionals, according to stratified risk level and HbA 1c level.…”

Section: Ramp-dm Interventionmentioning

confidence: 99%

Five-Year Cost-effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM)

et al. 2017

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OBJECTIVETo estimate the cost-effectiveness of the multidisciplinary Risk Assessment and Management Programme-Diabetes Mellitus (RAMP-DM) in primary care patients with type 2 diabetes in comparison with usual primary care in a cohort with 5 years' follow-up. RESEARCH DESIGN AND METHODSWe conducted a prospective cohort study among 17,140 propensity score-matched participants in RAMP-DM and those under usual primary care. The effectiveness measures were cumulative incidences of complications and all-cause mortality over 5 years. In a bottom-up approach, we estimated the program costs of RAMP-DM and health service utilization from the public health service provider's perspective. The RAMP-DM program costs included the setup costs, ongoing intervention costs, and central administrative costs. We calculated the incremental cost-effectiveness ratio by dividing the incremental costs by the incremental effectiveness of the RAMP-DM group compared with those of the usual-care group. RESULTSThere were significantly lower cumulative incidences of individual on any complications (15.34% vs. 28.65%, P < 0.001) and all-cause mortality (7.96% vs. 21.35%, P < 0.001) in the RAMP-DM group compared with the usual-care group. The mean program cost of RAMP-DM was 157 U.S. dollars (range 66-209) per participant over 5 years. The costs of health service utilization among participants in RAMP-DM group was 7,451 USD less than that of the usual-care group, resulting in a net savings of 7,294 USD per individual. CONCLUSIONSRAMP-DM added to usual primary care was a cost-saving intervention in managing diabetes in patients over 5 years. These findings support the integration of RAMP-DM as part of routine primary care for all patients with diabetes.The prevalence of diabetes is increasing globally. The latest estimation shows that there were 415 million people with diabetes all over the world by 2015, and the number is estimated to climb to 642 million by 2040 (1). China is among the countries with the highest diabetes prevalence: 11.6% among the adult population (2). Management of diabetes and diabetes-related complications posts a huge medical, social, and financial burden. It cost ;727 billion USD in total to manage diabetes in 2015, taking

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Section: Ramp-dm Interventionmentioning

confidence: 99%

Five-Year Cost-effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM)

et al. 2017

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“…The design, implementation and adoption of the JADE Program have been published. [10][11][12] In brief, the JADE Program is a web-based programme that uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver evidence-based care tailored to patients' risk profiles. All enrolled patients gave written informed consent to undergo comprehensive assessment, which includes clinical and demographic information and laboratory investigations at enrolment and at regular intervals thereafter.…”

Section: Study Subjects and Settingmentioning

confidence: 99%

Borderline ankle–brachial index is associated with increased prevalence of micro- and macrovascular complications in type 2 diabetes: A cross-sectional analysis of 12,772 patients from the Joint Asia Diabetes Evaluation Program

Yan¹,

Zhang

Kong³

et al. 2015

Diabetes and Vascular Disease Research

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Borderline ankle-brachial index is increasingly recognised as a marker of cardiovascular risk. We evaluated the impact of borderline ankle-brachial index in 12,772 Chinese type 2 diabetes patients from the Joint Asia Diabetes Evaluation Program between 2007 and 2012. Cardiovascular risk factors, complications and health-related quality of life were compared between patients with normal ankle-brachial index (1.0-1.4), borderline ankle-brachial index (0.90-0.99) and peripheral arterial disease (ankle-brachial index < 0.9). The prevalence of peripheral arterial disease and borderline ankle-brachial index was 4.6% and 9.6%, respectively. Borderline ankle-brachial index patients were older, more likely to be smokers and hypertensive, had longer duration of diabetes, poorer kidney function and poorer health-related quality of life than patients with normal ankle-brachial index. After adjustment for traditional cardiovascular risk factors, borderline ankle-brachial index was an independent predictor of diabetes-related micro-and macrovascular complications including retinopathy (odd ratios: 1.19 (95% confidence interval: 1.04-1.37)), macroalbuminuria (1.31 (1.10-1.56)), chronic kidney disease (1.22 (1.00-1.50)) and stroke (1.31 (1.05-1.64)). These findings suggest that patients with diabetes and borderline ankle-brachial index are at increased cardiovascular risk and may benefit from more intensive management.

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“…19 From our analysis of nationwide data, the highest prevalence was in females aged 40e65 years (46.15%), but this prevalence was lower than that reported in the JADE program or in the study by Xu and colleagues in China. 18,19 In our analysis, the prevalence of dyslipidemia in patients with microvascular complications remained stable. In patients with macrovascular complications, including all CVD and CVA, the prevalence of associated dyslipidemia decreased in both genders from 2000 to 2009.…”

Section: Discussionmentioning

confidence: 81%

“…17 Data from the Joint Asia Diabetes Evaluation (JADE) program from eight areas in Asia including Taiwan also showed that dyslipidemia and hypertension affected 76.8% and 84.6% of the patients, respectively. 18 In a study conducted by Xu et al in Beijing, China, the prevalence of lipid disorder was as high as 63.8% in the Chinese population in the Beijing area. 19 From our analysis of nationwide data, the highest prevalence was in females aged 40e65 years (46.15%), but this prevalence was lower than that reported in the JADE program or in the study by Xu and colleagues in China.…”

Section: Discussionmentioning

confidence: 98%

Prevalence of hypertension and dyslipidemia and their associations with micro- and macrovascular diseases in patients with diabetes in Taiwan: An analysis of nationwide data for 2000–2009

Tseng

Yin

et al. 2012

Journal of the Formosan Medical Association

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Although progressively increased prevalence of dyslipidemia and hypertension was observed in patients with diabetes in Taiwan, there was a decrease in the prevalence of stroke and CVD in the past 10 years. Among those with macrovascular diseases, except PVD, there was a trend of decreased prevalence of hypertension and dyslipidemia during the study period. In patients with microvascular diseases, prevalence of hypertension and dyslipidemia in patients with eye diseases increased in the past 10 years. More aggressive management of different risk factors is warranted in diabetic patients with various vascular diseases.

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Comprehensive risk assessments of diabetic patients from seven Asian countries: The Joint Asia Diabetes Evaluation (JADE) program*

Abstract: It is possible to use a web-based protocol to establish a registry for risk stratification and facilitate early intervention.

Cited by 50 publications

References 22 publications

Five-Year Cost-effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM)

Five-Year Cost-effectiveness of the Multidisciplinary Risk Assessment and Management Programme–Diabetes Mellitus (RAMP-DM)

Borderline ankle–brachial index is associated with increased prevalence of micro- and macrovascular complications in type 2 diabetes: A cross-sectional analysis of 12,772 patients from the Joint Asia Diabetes Evaluation Program

Prevalence of hypertension and dyslipidemia and their associations with micro- and macrovascular diseases in patients with diabetes in Taiwan: An analysis of nationwide data for 2000–2009

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