期刊
DIABETES CARE
卷 33, 期 4, 页码 733-735出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc09-1184
关键词
-
资金
- Division of Diabetes Translation, Centers for Disease Control and Prevention [04005]
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health [R01 DK065664, R01 DK080726, RC1 DK086178]
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-naive 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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