Evaluation of Quality of Care - Patient Empowerment Programme, HA (QoC PEP)
Diabetes mellitus (DM) and hypertension (HT) are major causes of morbidity and among the top 10 causes of deaths in Hong Kong in 2008 (Department of Health 2009). The Hospital Authority (HA) has initiated service improvement through introducing the patient empowerment programme (PEP) to improve the quality of care (QOC) for DM and HT patients. The evaluation on the QOC is an essential part of the programme in order to inform future policy. The Family Medicine Unit (FMU) of the University of Hong Kong (HKU) has been appointed by the HA to carry out the evaluation of the QOC of the programme.
The Action Learning and Audit Spiral methodologies to measure whether the target standard of care intended by the PEP programme is achieved. Each PEP participating clinic and non-government organization (NGO) will be invited to complete a structured evaluation questionnaire. The data of all patients who have enrolled into the PEP for more than one year will be included in the evaluation on the process and outcomes of care. A hundred and thirty participants will be followed up by telephone to evaluate the effect of the programme in quality of life (QOL), patient enablement, and global rating of change in health condition at baseline and 6 months after enrolment. Data on the process of care will be retrieved from the HA medical records. Main Outcome Measures: The primary outcomes are the proportion of participants who have received the planned process of care and achieved the target HbA1c and blood pressure levels.
Data Analysis: Descriptive statistics on proportions meeting the QOC criteria will be calculated. The changes in clinical, service, and patient reported outcomes at 6 and 12 months will assessed by paired sample t-test. The audit cycle will be repeated annually over a period of 5 years.
Results: The QOC of the PEP programme will be determined. Areas of deficiency and possible areas for quality enhancement will be identified. Conclusion: The results of this study will provide empirical evidence on whether the HA's PEP programme can enhance QOC for patients with diabetes mellitus (DM) or hypertension (HT). The information will be used to guide service planning and policy decision making.
調査の概要
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Hong Kong Island、香港
- The University of Hong Kong
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Eligible patients who are ambulatory, have stable mental and emotional conditions, and follow up at general outpatients clinics (GOPC) and family medicine specialist clinics (FMSC) regularly will be recruited for the PEP programme.
Exclusion Criteria:
- Patients will be excluded if they have severe heart failure, end stage renal failure (ESRF) or advanced eye diseases, are unable to understand or communicate in Chinese language, or refuse to give consent.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 観測モデル：コホート
- 時間の展望：見込みのある
コホートと介入
グループ/コホート |
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Diabetes mellitus (DM) and hypertension (HT)
Diabetes mellitus (DM) and/or hypertension (HT) patients in Hong Kong
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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The proportion of clinics/NGO that have satisfied each of the set structure criteria.
時間枠：Five years
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Interim analysis will evaluate the period from August, 2009 to December, 2010; to December, 2011; to December, 2012; to December, 2013.
Final analysis will evaluate the period from August, 2009 to December, 2014.
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Five years
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ケアの基準プロセスを遵守した患者の割合。
時間枠：5年
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中間分析では、2009 年 8 月から 2011 年 6 月までの期間を評価します。 2011 年 12 月まで。 2012 年 12 月まで。 2013 年 12 月まで。
最終分析では、2009 年 8 月から 2014 年 12 月までの期間を評価します。
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5年
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The proportion of DM patients who have achieved a HbA1c level <7%.
時間枠：Five years
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Interim analysis will evaluate the period from August, 2009 to June, 2011; to December, 2011; to December, 2012; to December, 2013.
Final analysis will evaluate the period from August, 2009 to December, 2014.
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Five years
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The proportion of HT/ DM patients who have achieved the target blood pressure.
時間枠：Five years
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Interim analysis will evaluate the period from August, 2009 to June, 2011; to December, 2011; to December, 2012; to December, 2013.
Final analysis will evaluate the period from August, 2009 to December, 2014.
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Five years
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Clinical outcomes including LDL, BMI, and cardiovascular complications.
時間枠：Five years
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Baseline and 12 months for each subject; the audit cycle will be repeated annually over a period of 5 years.
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Five years
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Patient reported outcomes (PRO) measured by the change in SF-12v2 scores, the Patient Enablement Index (PEI) and Global Rating of Change Score (GRS) at 6 months, and change in patient's knowledge on disease at 12 months.
時間枠：Five years
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Baseline and 6-month/12-month/24-month/36-month after the first administration of questionnaire.
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Five years
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GOPC consultation, SOPC, A&E and hospital attendance rates in the past 12 months.
時間枠：Five years
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Baseline and 12 months for each subject; the audit cycle will be repeated annually over a period of 5 years.
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Five years
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協力者と研究者
捜査官
- スタディチェア：Cindy L.K. Lam, MD、Department of Family Medicine and Primary Care, Faculty of Medicine, The University of Hong Kong
- 主任研究者：William C.W. Wong, MD、Department of Family Medicine and Primary Care, Faculty of Medicine, The University of Hong Kong
出版物と役立つリンク
一般刊行物
- Wong CK, Wong WC, Lam CL, Wan YF, Wong WH, Chung KL, Dai D, Tsui EL, Fong DY. Effects of Patient Empowerment Programme (PEP) on clinical outcomes and health service utilization in type 2 diabetes mellitus in primary care: an observational matched cohort study. PLoS One. 2014 May 1;9(5):e95328. doi: 10.1371/journal.pone.0095328. eCollection 2014.
- Wong CK, Wong WC, Wan YF, Chan AK, Chung KL, Chan FW, Lam CL. Patient Empowerment Programme in primary care reduced all-cause mortality and cardiovascular diseases in patients with type 2 diabetes mellitus: a population-based propensity-matched cohort study. Diabetes Obes Metab. 2015 Feb;17(2):128-35. doi: 10.1111/dom.12397. Epub 2014 Oct 20.
- Wong CK, Wong WC, Wan YF, Chan AK, Chan FW, Lam CL. Patient Empowerment Programme (PEP) and Risk of Microvascular Diseases Among Patients With Type 2 Diabetes in Primary Care: A Population-Based Propensity-Matched Cohort Study. Diabetes Care. 2015 Aug;38(8):e116-7. doi: 10.2337/dc14-2213. No abstract available.
- Wong CK, Wong WC, Wan EY, Wong WH, Chan FW, Lam CL. Increased number of structured diabetes education attendance was not associated with the improvement in patient-reported health-related quality of life: results from Patient Empowerment Programme (PEP). Health Qual Life Outcomes. 2015 Aug 12;13:126. doi: 10.1186/s12955-015-0324-3.
- Wong CK, Wong WC, Wan EY, Chan AK, Chan FW, Lam CL. Macrovascular and microvascular disease in obese patients with type 2 diabetes attending structured diabetes education program: a population-based propensity-matched cohort analysis of Patient Empowerment Programme (PEP). Endocrine. 2016 Aug;53(2):412-22. doi: 10.1007/s12020-015-0843-z. Epub 2016 Jan 19.
- Wong CK, Wong WC, Wan YF, Chan AK, Chan FW, Lam CL. Effect of a structured diabetes education programme in primary care on hospitalizations and emergency department visits among people with Type 2 diabetes mellitus: results from the Patient Empowerment Programme. Diabet Med. 2016 Oct;33(10):1427-36. doi: 10.1111/dme.12969. Epub 2015 Oct 27.
- Wong CK, Lam CL, Wan EY, Chan AK, Pak CH, Chan FW, Wong WC. Evaluation of patient-reported outcomes data in structured diabetes education intervention: 2-year follow-up data of patient empowerment programme. Endocrine. 2016 Nov;54(2):422-432. doi: 10.1007/s12020-016-1015-5. Epub 2016 Sep 13.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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