Primary care physician perspectives on basal insulin initiation and maintenance in patients with type 2 diabetes mellitus
Primary care physician perspectives on basal insulin initiation and maintenance in patients with type 2 diabetes mellitus
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DOI：
10.1016/j.pcd.2017.10.001
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发表时间：
2018-04-01
影响因子：
2.9
通讯作者：
Fisher, Lawrence
中科院分区：
文献类型：
--
作者：
Kalirai, Samaneh;Stephenson, Judith;Fisher, Lawrence
目的：描述初级保健医生（PCPs）的看法，病人的反应和关注胰岛素启动和确定机会增加supports.Methods：横断面，在线调查的PCPs处方基础胰岛素的成人2型糖尿病（T2 DM）。PCP的大型商业健康计划的行政索赔和描述性结果的PCP响应reported.Results：PCP（N =100）治疗平均17例患者接受胰岛素在一个典型的一周。超过85%的胰岛素启动建议来自PCP。大多数提供血糖监测说明（96%）和饮食，运动和糖尿病管理建议（96%）; 35%提供胰岛素滴定算法; 93%报告患者在开始后3个月内经常或总是每天服用胰岛素; 31%的PCP报告前3个月每月与患者进行办公室联系; 16%报告没有外展工作;只有不到20%的人将患者与支持团体联系起来。当开始使用基础胰岛素时，PCP报告患者感觉自己的糖尿病治疗失败（33%经常/总是），对自己管理胰岛素治疗的能力缺乏信心（38%经常/总是）。结论：研究结果确定了帮助患者过渡到胰岛素的额外机会，包括更频繁的直接外展监测胰岛素的使用。(C)2017年，作者。由Elsevier Ltd代表Primary Care Diabetes Europe出版。
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. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of Primary Care Diabetes Europe.