Barriers to Insulin Initiation The Translating Research Into Action for Diabetes Insulin Starts Project

Date
2010-04
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American English
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Abstract

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.

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Karter, A. J., Subramanian, U., Saha, C., Crosson, J. C., Parker, M. M., Swain, B. E., ... & Marrero, D. G. (2010). Barriers to Insulin Initiation The Translating Research Into Action for Diabetes Insulin Starts Project. Diabetes Care, 33(4), 733-735.
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