DDI-CHE-QDiab-2017-V1
CoDiab-VD: Cohort of Patients with Diabetes in the Canton of Vaud (Switzerland)
Codiab-VD : Cohorte des patient·e·s diabétiques du canton de Vaud (Suisse)
| Name | Country code |
|---|---|
| Switzerland | CHE |
Prospective cohort study
The first recruitment in the cohort of individuals with diabetes took place in 2011-12. Since then, participants were followed up annually up to 2017. A second recruitment was performed in 2017. Participants will be followed up every two years from 2017, up to 2021.
The Department of Health and Social Welfare (DSAS) of the canton of Vaud launched in 2010, through its Public Health Service (SSP), an innovative programme to tackle the burden of diabetes in the canton of Vaud: the Programme cantonal Diabète (PcD). Its aims was to lower diabetes incidence and prevalence, and to improve quality of diabetes care.
As part of the development and the evaluation of the PcD, the Institute of Social and Preventive Medicine (IUMSP) of Lausanne was mandated to conduct a survey aiming at characterising individuals with diabetes in the canton of Vaud and describing their diabetes care. Individuals participating in the study in 2011-2012 constituted the baseline of the cohort (CoDiab-VD). Participants were followed up annually from 2013 to 2017. In 2017 a second recruitment of individuals with diabetes was performed. Further follow-ups are planned in 2019 and 2021.
Recruitments were performed through community pharmacies. Were eligible: adult individuals (≥18 years) with a diagnosis of any type of diabetes for at least 12 months, going to a pharmacy with a diabetes-related prescription, who were non-institutionalized (in an institution for elderly or disabled people), who were living in the canton of Vaud (Switzerland) and who consented to participate in the study. Were not eligible: individuals with gestational diabetes, without sufficient French knowledge to understand and fill in the questionnaire, and with cognitive impairment. Individuals accepting to participate received a questionnaire that they filled in at home and sent back to the investigators. Annual follow-up questionnaires were sent to the participants by regular post mail.
Data collected with the self-assessed questionnaires encompass several aspect of diabetes and diabetes care, such as processes and outcomes of care, self-management, daily diabetes management and healthcare utilisation, as well as general health status, health habits, and sociodemographic characteristics. Participants’ GP and/or diabetologist were also contacted in 2011-12 and 2014 when their contact details were provided, to get some clinical and processes data.
In 2011-2012, 519 patients with diabetes were included in the study. Their mean age was 65 years, 60% were males, more than 80% were overweight or obese, 17% smoked, 30% were physically inactive and 83% had at least one other chronic condition. A large majority of participants had type 2 diabetes (85%), were treated by oral antidiabetics (80%) and 53% had no diabetes-related complications.
Among processes of care received during the past 12 months, the processes relating to usual controls performed during a medical appointment and those relating to laboratory analyses were considered satisfactory, with more than 90% of respondents reporting glycated haemoglobin (HbA1c), lipid, blood pressure and weight measurements. However, diabetes-specific processes were less satisfactory, with less than 70% of the participants mentioning urine microalbuminuria, diabetic retinopathy and foot controls as well as influenza vaccination. Recommendations about physical activity and dietetics were reported by 69% and 49%, respectively. By contrast, only 5% of the total sample were smokers who did not receive tobacco cessation advice. If more than 80% of respondents reported home glucose monitoring, only 33% had ever participated in a diabetes education class.
On the outcomes of care side, the mean HbA1c was 7.3%, and 6% of patients had a value higher than 9.0%. Regarding generic health-related quality of life, the mental dimension scored better than the physical dimension. The aspects of diabetes-specific quality of life that were the most impacted by diabetes were “freedom to eat”, “sex life”, “freedom to drink” and “feelings about future”. The evaluation of the congruence of care with the Chronic Care Model (CCM) got the lowest score for the two questions regarding “encouragement to attend group or class to help cope with diabetes” and “encouragement to attend community programmes that could be of help”, and the highest score for the question regarding “satisfaction with healthcare organisation”.
A large majority of participants reported a least one consultation per year with a physician (general practitioner or diabetologist, 97%). The consultation of other healthcare professionals involved in diabetes care were less frequently reported; most respondents had no visit to specialised nurse (80%), dietician (76%) and podiatrist (62%) during the past 12 months.
Globally, this first picture showed that diabetes care was good with respects to recommendations made by the Swiss Society of Endocrinology and Diabetology, but that room for improvement remained. Six years after this initial recruitment, the second picture obtained in 2017 showed quite similar results.
The CoDiab-VD study is registered with ClinicalTrials.gov, identifier NCT01902043.
The protocol of the study has been published and is available under the reference: Zuercher E, Bordet J, Burnand B, Peytremann-Bridevaux I. CoDiab-VD: protocol of a prospective population-based cohort study on diabetes care in Switzerland. BMC Health Serv Res. 2015;15:329. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26272346
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536695/pdf/12913_2015_Article_991.pdf
Recruitments’ results are available from:
Peytremann-Bridevaux I, Bordet J, Zuercher E, Burnand B. Caractéristiques des patients diabétiques vaudois et évaluation de leur prise en charge : Rapport final (Recrutements 2011 et 2012). Lausanne Institut universitaire de médecine sociale et préventive, 2013. (Raisons de santé 211). Available from: http://www.iumsp.ch/Publications/pdf/rds211_fr.pdf
Antille-Zuercher E, Carron T, Peytremann-Bridevaux I. Cohorte CoDiab-VD : Caractéristiques des patient·e·s diabétiques vaudois·es et évaluation de leur prise en charge : Etat des lieux en 2017 et comparaison avec 2011-2012. Lausanne: Institut universitaire de médecine sociale et préventive (IUMSP), 2019. (Raisons de santé 293). Available from: https://www.iumsp.ch/Publications/pdf/rds293_fr.pdf
Peytremann-Bridevaux I, Bordet J, Santschi V, Collet TH, Eggli M, Burnand B. Community-based pharmacies: an opportunity to recruit patients? International journal of public health. 2013 Jul 1;58(2):319-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22752242
http://link.springer.com/content/pdf/10.1007/s00038-012-0383-8.pdf
Peytremann-Bridevaux I, Bordet J, Burnand B. Diabetes care in Switzerland: good, but perfectible: a population-based cross-sectional survey. BMC Health Serv Res. 2013;13:232. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23800376
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722105/pdf/1472-6963-13-232.pdf
Zuercher E, Casillas A, Hagon-Traub I, Bordet J, Burnand B, Peytremann-Bridevaux I. Baseline data of a population-based cohort of patients with diabetes in Switzerland (CoDiab-VD). Swiss Med Wkly. 2014;144:w13951. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24863132
Sample survey data [ssd] / Self-reported data collected from paper questionnaire
The analysis unit is the individual.
At time of the first recruitment in 2011-12, the number of survey participants were 519. From this baseline number, the participants of the follow-ups were 395 in 2013, 339 in 2014, 323 in 2015, 295 in 2016 and 276 in 2017.
At the time of the second recruitment in 2017, 514 new individuals were enrolled in the study and answered the survey questionnaire.
Therefore, in 2017, 790 participants answered to the questionnaire (276 + 514).