Maladies chroniques et populations vulnérables : état des lieux et vision d’avenir [Non-communicable diseases and vulnerable populations: overview of the situation and vision for the future]

The care of vulnerable people with non-communicable diseases faces numerous barriers including difficulties in identifying affected people, lack of time, resources, tools and skills to address these issues, poor intersectoral work between health-care and social work. We plea for a systematic public policy which allows to implement intersectoral collaborations at all levels

Urgences hyperglycémiques en pratique ambulatoire - Prise en charge multidisciplinaire du diabète : recommandations pour la pratique clinique

L’élaboration et la mise en œuvre de ces recommandations pour la pratique clinique (RPC) visent à promouvoir l’application pertinente et coordonnée de pratiques de soins optimales d’un diabète par l’ensemble des professionnels des soins concernés. Ces RPC ont également pour but de fédérer et d’harmoniser la prise en charge du diabète, qui est actuellement très variable dans le canton de Vau

Baseline data of a population-based cohort of patients with diabetes in Switzerland (CoDiab-VD)

QUESTIONS UNDER STUDY: To describe a population-based sample of patients with diabetes and the quality of their care in the canton of Vaud, Switzerland, as a baseline measure for the evaluation of the "Programme cantonal Diabète". METHODS: We conducted a self-administered paper-based questionnaire survey. Non-institutionalised adult (aged ≥18 years) patients with diabetes diagnosed for at least 1 year and residing in the canton of Vaud were recruited by community pharmacies. Women with gestational diabetes, people with obvious cognitive impairment or people not sufficiently fluent in French were excluded. Primary outcomes were recommended processes-of-care and outcomes of care (glycosylated haemoglobin [HbA1c], generic and disease-specific health-related quality of life (HRQoL), overall care score in relation to the Chronic Care Model). Other measures included diabetes education, self-management support and self-efficacy, health status, health behaviour and demographics. RESULTS: A total of 519 patients with diabetes were included. Whereas the mean HbA1c level was 7.3% (n = 177, 95% confidence interval 7.1-7.5), diabetes-specific processes-of-care and influenza vaccination were reported by less than two-thirds of the patients. Physical activity and diet recommendations results mirrored patients' difficulties with their management in daily life and diabetes-specific HRQoL was worst in the dimensions relative to diet (eating and drinking) and sex life. A minority of patients reported ever having participated in diabetes education courses (32.8%). Overall, patients were satisfied with their care and the support they received. CONCLUSIONS: This study provides a broad picture of the experiences of people living with diabetes in the canton of Vaud. It shall guide the development of targeted interventions within the "Programme cantonal Diabète"

Conduite automobile et diabète: Prise en charge multidisciplinaire du diabète : recommandations pour la pratique clinique

L’élaboration et la mise en œuvre de ces recommandations pour la pratique clinique (RPC) visent à promouvoir l’application pertinente et coordonnée de pratiques de soins optimales d’un diabète par l’ensemble des professionnels des soins concernés. Ces RPC ont également pour but de fédérer et d’harmoniser la prise en charge du diabète, qui est actuellement très variable dans le canton de Vaud. L’ESSENTIEL Devoir d’information des soignants chez une personne diabétique traitée par un hypoglycémiant - Informer la personne sur la conduite et le diabète et documenter la transmission de ces informations

Awareness and practices regarding eye diseases among patients with diabetes: a cross sectional analysis of the CoDiab-VD cohort.

The increasing prevalence of diabetes is leading to a rise of eye diseases, augmenting the risk of sight-threatening complications. The aim of this study was to evaluate prevalence, awareness and practices regarding eye diseases among patients with diabetes in the canton of Vaud, Switzerland. A cohort of 323 patients with diabetes completed a self-administered questionnaire assessing prevalence, awareness and practices regarding eye diseases, besides health status and quality of care measures. Descriptive analyses followed by exploratory subgroup analyses and linear regressions were performed to investigate factors associated with awareness and practices. While diabetic retinopathy was reported by 40.9% of patients with type 1 diabetes and 9.8% of patients with type 2 diabetes, 35.8% and 12.6% of all participants reported cataract and glaucoma, respectively. Awareness that diabetes could damage the eyes was reported by almost all participants; the majority was also aware of the importance of glycemic control and regular eye examination in preventing eye diseases. In contrast, only 70.5% of participants underwent an eye examination by an ophthalmologist during the past year. Eye examination was associated with better patients' awareness. Barriers mentioned by patients revealed a lack of knowledge about screening guidelines, in particular regarding the preventive nature of eye examinations. Despite high levels of awareness regarding diabetic eye diseases, a significant proportion of patients with diabetes did not report annual eye examination. Both healthcare strategic efforts targeting the promotion of regular eye examination and initiatives aiming at improving knowledge of screening guidelines should be encouraged. ClinicalTrials.gov on 9th July 2013, identifier NCT01902043 (retrospectively registered)