2. Riviera Chablais Hospital, Site du Samaritain, Boulevard Paderewski 3, 1800 Vevey, Switzerland.
3. Institut of Social and Preventive Medicine (IUMSP), Rue duBugnon 44, 1011 Lausanne, Switzerland.
4. Department of Ambulatory Care and Community Medicine (PMU), Rue de Bugnon 44, 1011 Lausanne, Vaud, Switzerland.
Purpose: The purpose of this study is to 1) evaluate perceived risk for diabetes among type 2 diabetes patients with different types of diabetes follow-up: diabetologist, general practitioner, or both (“combined follow-up”) in the community and university settings and 2) determine the prognostic factors for better/ higher risk perception of diabetes among these patients.
Methods: In this cross-sectional study, we quantified diabetes risk perception using Walker’s RPS-DM survey. The PRIME-MD PHQ questionnaire was used to screen for mood and anxiety disorders. The global risk perception scores were coded in two categories (low/high) and compared across the various types of medical follow-up; univariate and multivariate logistic regression techniques were used to examine the association between perceived risk, patients’ sociodemographic factors, diabetes characteristics and psychological profile.
Results: Univariate analysis in logistic regression showed that having combined diabetes follow-up in the university setting was significantly associated with higher composite risk perception (OR=14; 95% CI 3.56-55.05) compared to patients with either single provider type follow-up. Specifically, combined followup, was linked to diabetes worry (OR=6.45; 95% CI 1.68-24.7), but also higher perceived risk for diabetes complications (OR=3.55; 95% CI 1.12-11.2). These analyses also showed that perceived risk for diabetes complications was associated with longer diabetes duration (OR=1.05; 95% CI 1.01-1.09), higher number of drug therapies (OR=1.35; 95% CI 1.08-1.69), increased microvascular complications (OR=1.47; 95% CI 1.03- 2.10) and increased vascular complications (OR=1.31; 95% CI 1.02-1.71).
Conclusions: Having combined follow-up in the same medical institution increases a patient’s perceived risk of the complications of his/her diabetic illness. Having a more accurate self-perception of potential diabetic complications may help patients make healthier and informed lifestyle choices. Future studies should further examine the association between combined provider follow-up and risk perception, and focus on how patient-provider relationships and follow-up impact diabetic patient outcomes.
Keywords: Type 2 diabetes mellitus, behavior, risk, ambulatory care, patient care team, general practitioner