Correlates of insulin injection omission.
Correlates of insulin injection omission.
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DOI：
10.2337/dc09-1348
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发表时间：
2010-02
期刊：
影响因子：
16.2
通讯作者：
Travis LB
中科院分区：
文献类型：
--
作者：
Peyrot M;Rubin RR;Kruger DF;Travis LB
本研究的目的是评估与患者故意不注射胰岛素频率相关的因素。数据是通过一项网络调查获得的，调查对象是502名美国成年人，他们认为自己注射胰岛素治疗1型或2型糖尿病。多元回归分析评估了各种人口统计学、疾病和注射特异性因素与胰岛素遗漏的独立关联。一半以上的应答者报告故意遗漏胰岛素；经常漏报的占20%。胰岛素遗漏的重要独立危险因素有：年龄较小、收入较低、教育程度较高、2型糖尿病、不遵循健康饮食、每日注射次数较多、注射干扰日常活动、注射疼痛和尴尬。1型和2型糖尿病患者的危险因素不同，1型糖尿病患者的饮食不依从性更突出，而2型糖尿病患者的年龄、教育程度、收入、疼痛和尴尬更突出。尽管大多数患者没有报告定期故意遗漏胰岛素注射，但有相当数量的患者确实如此。我们的研究结果表明，识别故意不使用胰岛素的患者并意识到这里确定的潜在危险因素是很重要的。对于报告注射相关问题（干扰日常活动、注射疼痛和尴尬）的患者，提供者应考虑推荐解决这些问题的策略和工具，以增加胰岛素处方方案的依从性。这可以改善临床结果。
The purpose of this study was to assess factors associated with patient frequency of intentionally skipping insulin injections. Data were obtained through an Internet survey of 502 U.S. adults self-identified as taking insulin by injection to treat type 1 or type 2 diabetes. Multiple regression analysis assessed independent associations of various demographic, disease, and injection-specific factors with insulin omission. Intentional insulin omission was reported by more than half of respondents; regular omission was reported by 20%. Significant independent risk factors for insulin omission were younger age, lower income and higher education, type 2 diabetes, not following a healthy diet, taking more daily injections, interference of injections with daily activities, and injection pain and embarrassment. Risk factors differed between type 1 and type 2 diabetic patients, with diet nonadherence more prominent in type 1 diabetes and age, education, income, pain, and embarrassment more prominent in type 2 diabetes. Whereas most patients did not report regular intentional omission of insulin injections, a substantial number did. Our findings suggest that it is important to identify patients who intentionally omit insulin and be aware of the potential risk factors identified here. For patients who report injection-related problems (interference with daily activities, injection pain, and embarrassment), providers should consider recommending strategies and tools for addressing these problems to increase adherence to prescribed insulin regimens. This could improve clinical outcomes.