Author(s)

Sophie Excoffier¹, Manuel Raphael Blum², Nicolas Rodondi², Jacques Cornuz³, Lukas Zimmerli⁴, Jean-Michel Gaspoz¹, Idris Guessous^1,5,6

¹Unit of Population Epidemiology, Division of primary care medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospital, Geneva, Switzerland.
²Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland.
³Department for Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
⁴Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland.
⁵Division of Chronic Diseases, Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
⁶Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA.

Background: Preventive care of diabetic foot and eye complications is essential. However, data on the prevalence of and factors associated with screening of angiopathic complications in ambulatory patients with diabetes are very limited in Switzerland. We aimed to fill this gap of knowledge. Methods: Cross-sectional data on recommended preventive care using RAND’s criteria in a random sample of patients aged 50-80 years in 2005-2006. Participants were recruited from 4 Swiss university primary care settings (in Lausanne, Geneva, Zürich and Basel). Scores for general preventive care in patients with and without diabetes were calculated by using generalized estimating equation binomial models. Multivariate regression models were used to identify determinants of appropriateness of angiopathic complications prevention. The main outcome measure was appropriateness of screening for angiopathic complications based on the 2005 American Diabetes Association recommendations corresponding to the period of data collection. Results: Among the 1002 patients aged 50 - 80 years, 292 (29.1%) had diabetes (101/292 [34.6%] female, mean BMI 30.7 [SD 5.7]). Fifty-nine percent had appropriate preventive foot care and 55.8% had appropriate preventive eye care. Only 34.6% had appropriate preventive care of both foot and eye. No differences in aggregate scores for general preventive care in patients with and without diabetes were found (67.5% vs. 69.1%, p value 0.39). In multivariate model, obesity was negatively (OR = 0.28, 0.15 - 0.53) and hyperlipidemia positively (OR = 2.29, 1.20 - 4.38) associated with appropriate eye preventive care and with appropriate combined foot and eye preventive care (OR = 0.35, 0.18 - 0.70 for obesity and OR = 2.82, 1.24 - 6.40 for hyperlipidemia). Conclusions: Preventive care of diabetic angiopathic complications is low among ambulatory patients despite universal health care coverage. Particular attention should be paid to obese patients with diabetes.

Diabetes, Appropriateness, Angiopathic Complications, Prevention, Primary Care

Excoffier, S. , Raphael Blum, M. , Rodondi, N. , Cornuz, J. , Zimmerli, L. , Gaspoz, J. and Guessous, I. (2015) Appropriateness of Screening of Angiopathic Complications Prevention in Ambulatory Patients with Diabetes. Open Journal of Preventive Medicine, 5, 244-258. doi: 10.4236/ojpm.2015.56028.