title: [Implementation of a diabetes disease management program in Switzerland: patients' and healthcare professionals' point of view].
abstract: BACKGROUND
  A reorganization of healthcare systems is required to meet the challenge of the increasing prevalence of chronic diseases, e.g. diabetes. In North-America and Europe, several countries have thus developed national or regional chronic disease management programs. In Switzerland, such initiatives have only emerged recently. In 2010, the canton of Vaud set up the "Diabetes Cantonal Program", within the framework of which we conducted a study designed to ascertain the opinions of both diabetic patients and healthcare professionals on the elements that could be integrated into this program, the barriers and facilitators to its development, and the incentives that could motivate these actors to participate.
  
  
  METHODS
  We organized eight focus-groups: one with diabetic patients and one with healthcare professionals in the four sanitary areas of the canton of Vaud. The discussions were recorded, transcribed and submitted to a thematic content analysis.
  
  
  RESULTS
  Patients and healthcare professionals were rather in favour of the implementation of a cantonal program, although patients were more cautious concerning its necessity. All participants envisioned a set of elements that could be integrated to this program. They also considered that the program could be developed more easily if it were adapted to patients' and professionals' needs and if it used existing structures and professionals. The difficulty to motivate both patients and professionals to participate was mentioned as a barrier to the development of this program however. Quality or financial incentives could therefore be created to overcome this potential problem.
  
  
  CONCLUSIONS
  The identification of the elements to consider, barriers, facilitators and incentives to participate to a chronic disease management program, obtained by exploring the opinions of patients and healthcare professionals, should favour its further development and implementation.
authors.affiliation: Institut universitaire de médecine sociale et préventive (IUMSP), centre hospitalier universitaire Vaudois et université de Lausanne, Biopôle 2, route de la Corniche 10, 1010 Lausanne, Suisse.
authors.forename: S
authors.initials: S
authors.lastname: Lauvergeon
authors.forename: B
authors.initials: B
authors.lastname: Burnand
authors.forename: I
authors.initials: I
authors.lastname: Peytremann-Bridevaux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology; D006284:Health Plan Implementation / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010361:Patients / Q000523:psychology; D010465:Perception; D012424:Rural Population / Q000706:statistics & numerical data; D013557:Switzerland; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Diabetes mellitus; Diabète sucré; Disease management; Gestion des maladies chroniques; Health personnel; Patients; Personnel de santé; Qualitative research; Recherche qualitative