Trajectories of seasonal influenza vaccine uptake among French people with diabetes: a nationwide retrospective cohort study, 2006–2015

Bocquier, Aurélie; Cortaredona, Sébastien; Fressard, Lisa; Loulergue, Pierre; Raude, Jocelyn; Sultan, Ariane; Galtier, Florence; Verger, Pierre

doi:10.1186/s12889-019-7209-z

Table 2 Risk factors for membership in SIV-uptake trajectories – group-based trajectory model, multinomial logistic regression^a (EGB, France, 2006/07–2015/16, n = 15,766^b)

From: Trajectories of seasonal influenza vaccine uptake among French people with diabetes: a nationwide retrospective cohort study, 2006–2015

	Trajectory (ref. 1. Continuously vaccinated - n = 4344 (27.6%)
	2. Progressively less vaccinated	3. Post pandemic decreasingly vaccinated	4. Early increasingly vaccinated	5. Late increasingly vaccinated	6. Never vaccinated
	n = 2832	n = 1627	n = 1472	n = 763	n = 4728
	18.0%	10.3%	9.3%	4.8%	30.0%
	Adjusted risk ratio [95% confidence interval]
Sociodemographic characteristics
Age at inclusion > 65	2.89 [2.47;3.33]	0.68 [0.60;0.78]	0.33 [0.28;0.38]	0.14 [0.11;0.18]	0.56 [0.52;0.61]
Women	0.82 [0.75;0.91]	1.38 [1.26;1.51]	0.99 [0.88;1.10]	0.98 [0.83;1.14]	1.09 [1.05;1.14]
Clinical characteristics
Type and treatment of diabetes at inclusion
Type 1^c	0.99 [0.83;1.16]	1.11 [0.95;1.30]	0.76 [0.59;0.97]	0.53 [0.37;0.76]	0.85 [0.76;0.94]
Other types -- no antidiabetic drug	1.18 [1.01;1.36]	1.61 [1.39;1.85]	3.04 [2.77;3.29]	2.10 [1.69;2.56]	1.62 [1.54;1.68]
Diabetes treatment intensification^d during follow-up	0.76 [0.68;0.84]	1.04 [0.94;1.15]	1.23 [1.09;1.39]	1.25 [1.06;1.47]	0.96 [0.91;1.01]
Weighted individual chronic condition score^e at inclusion ≥ median	1.16 [1.04;1.28]	0.87 [0.78;0.97]	0.77 [0.68;0.87]	0.81 [0.68;0.96]	0.75 [0.71;0.80]
Course of weighted individual chronic condition score^e during follow-up
Stable	1.33 [1.06;1.60]	0.81 [0.55;1.13]	0.68 [0.40;1.11]	0.83 [0.40;1.62]	1.45 [1.33;1.57]
Increasing	0.99 [0.90;1.08]	0.73 [0.66;0.81]	1.19 [1.05;1.34]	1.21 [1.02;1.43]	0.89 [0.83;0.94]
Hospitalized during follow-up
For diabetes and its complications	1.05 [0.94;1.16]	1.23 [1.11;1.37]	1.01 [0.88;1.15]	1.02 [0.85;1.22]	1.05 [1.00;1.11]
For influenza and its complications	1.32 [1.16;1.48]	1.44 [1.22;1.67]	1.46 [1.20;1.75]	1.30 [0.91;1.81]	0.98 [0.87;1.09]
Healthcare utilization
Frequent consultations during follow-up, with:
General practitioner	1.92 [1.76;2.07]	1.02 [0.91;1.14]	0.95 [0.83;1.07]	0.80 [0.66;0.96]	0.85 [0.80;0.90]
Endocrinologist	0.77 [0.65;0.91]	0.70 [0.59;0.83]	0.82 [0.69;0.97]	0.64 [0.49;0.83]	0.84 [0.78;0.91]
Cardiologist	1.00 [0.90;1.11]	0.79 [0.69;0.92]	0.87 [0.74;1.01]	0.71 [0.55;0.91]	0.79 [0.73;0.86]
Change of general practitioner during follow-up	0.73 [0.66;0.81]	0.98 [0.89;1.08]	0.94 [0.84;1.05]	1.13 [0.97;1.31]	0.93 [0.88;0.97]

Reference groups. Age: “≤ 65 years”; gender: “men”; type and treatment of diabetes at inclusion: “other types -- ≥ 1 antidiabetic drug”; diabetes treatment intensification: “no”; weighted individual chronic condition score at inclusion: “< median”; course of weighted individual chronic condition score: “decreasing”; hospitalized during follow-up: “no”; consultations during follow-up: “number of consultations < median”; change of general practitioner: “no”
Boldface indicates statistical significance (p ≤ 0.05)
^aModel adjusted for all variables displayed in the Table, as well as for district of residence (results not displayed): Paris region, northwest, northeast, southeast, and southwest. The variable “Received the free vaccination voucher” was not included in the model due to strong correlation with age (all people aged 65 years or older receive this voucher)
^bAmong individuals with at least two full years of follow-up (n = 15,766, 90.2%), to enable calculation of two variables included in the model (i.e., diabetes treatment intensification and course of weighted individual chronic condition score during follow-up).
^cPeople with type 1 diabetes were those with long-term illness status for type 1 diabetes (E10 according to the ICD-10) and treated by insulin at inclusion
^d“Intensification” was defined by at least one of the following modifications during follow-up: from no antidiabetic drug to at least one antidiabetic drug; from only one to at least two noninsulin antidiabetic drugs or insulin; from at least two noninsulin antidiabetic drugs to insulin
^eThe individual chronic condition score (ICC) was calculated as a weighted sum of 21 chronic conditions. Weights account for the severity of each condition in the score calculation (ICC range in study cohort: min = 0; max = 3.7)

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