Primary care physician perspectives on basal insulin initiation and maintenance in patients with type 2 diabetes mellitus.

Autor: Kalirai S; Eli Lilly and Company, Indianapolis, IN, USA. Electronic address: samaneh.kalirai@lilly.com., Stephenson J; HealthCore, Inc., Wilmington, DE, USA., Perez-Nieves M; Eli Lilly and Company, Indianapolis, IN, USA., Grabner M; HealthCore, Inc., Wilmington, DE, USA., Hadjiyianni I; Eli Lilly and Company, Indianapolis, IN, USA., Geremakis C; Biogen, Inc., Cambridge, MA, USA., Pollom RD; Eli Lilly and Company, Indianapolis, IN, USA., Reed B; Eli Lilly and Company, Indianapolis, IN, USA., Fisher L; Department of Family and Community Medicine, UC San Francisco, San Francisco, CA, USA.
Jazyk: angličtina
Zdroj: Primary care diabetes [Prim Care Diabetes] 2018 Apr; Vol. 12 (2), pp. 155-162. Date of Electronic Publication: 2017 Oct 31.
DOI: 10.1016/j.pcd.2017.10.001
Abstrakt: Aims: To describe primary care physicians' (PCPs) perceptions of patient reactions and concerns about insulin initiation and identify opportunities for increased support.
Methods: Cross-sectional, online survey of PCPs prescribing basal insulin to adults with type 2 diabetes mellitus (T2DM). PCPs were identified from administrative claims of a large commercial health plan and descriptive results of PCP responses were reported.
Results: PCPs (N=100) treated an average of 17 patients receiving insulin during a typical week. More than 85% of insulin initiation recommendations originated with PCPs. Most offered glucose monitoring instructions (96%) and advice on diet, exercise, and diabetes management (96%); 35% provided insulin titration algorithms; 93% reported that patients often or always took their insulin daily within 3 months of initiation; 31% of PCPs reported monthly office contacts with patients for the first 3 months; 16% reported no outreach efforts; fewer than 20% connected patients with support groups. When starting basal insulin, PCPs reported patients feeling personal failure regarding their diabetes treatment (33% often/always) and lacking confidence in their ability to manage insulin therapy (38% often/always).
Conclusions: Study results identify additional opportunities for assisting patients in making the transition to insulin, including more frequent direct outreach to monitor insulin usage.
(Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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