Barriers to Insulin Initiation
| Autor: | Howard H. Moffet, David G. Marrero, Chandan Saha, Jesse C. Crosson, Usha Subramanian, Melissa M. Parker, Andrew J. Karter, Bix E. Swain |
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| Rok vydání: | 2010 |
| Předmět: |
Advanced and Specialized Nursing
Research design medicine.medical_specialty business.industry Endocrinology Diabetes and Metabolism Public health Insulin medicine.medical_treatment Health literacy Type 2 diabetes Hypoglycemia medicine.disease Endocrinology Internal medicine Diabetes mellitus Internal Medicine medicine Medical prescription Intensive care medicine business |
| Zdroj: | Diabetes Care. 33:733-735 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc09-1184 |
| Popis: | OBJECTIVE Reasons for failing to initiate prescribed insulin (primary nonadherence) are poorly understood. We investigated barriers to insulin initiation following a new prescription. RESEARCH DESIGN AND METHODS We surveyed insulin-naïve patients with poorly controlled type 2 diabetes, already treated with two or more oral agents who were recently prescribed insulin. We compared responses for respondents prescribed, but never initiating, insulin (n = 69) with those dispensed insulin (n = 100). RESULTS Subjects failing to initiate prescribed insulin commonly reported misconceptions regarding insulin risk (35% believed that insulin causes blindness, renal failure, amputations, heart attacks, strokes, or early death), plans to instead work harder on behavioral goals, sense of personal failure, low self-efficacy, injection phobia, hypoglycemia concerns, negative impact on social life and job, inadequate health literacy, health care provider inadequately explaining risks/benefits, and limited insulin self-management training. CONCLUSIONS Primary adherence for insulin may be improved through better provider communication regarding risks, shared decision making, and insulin self-management training. |
| Databáze: | OpenAIRE |
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