Differences in physician and patient perceptions about insulin therapy for management of type 2 diabetes: the DAWN Japan study
Differences in physician and patient perceptions about insulin therapy for management of type 2 diabetes: the DAWN Japan study
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DOI：
10.1185/03007995.2013.855187
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发表时间：
2014-02-01
影响因子：
2.3
通讯作者：
Iwamoto, Yasuhiko
中科院分区：
文献类型：
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作者：
Yoshioka, Narihito;Ishii, Hitoshi;Iwamoto, Yasuhiko
目的：为了更好地了解患者对开始胰岛素治疗的抵抗，本研究利用 DAWN Japan 研究的数据，调查了 2 型糖尿病患者与其医生之间对于开始胰岛素治疗的认知差距。 方法：DAWN Japan 研究是一项多中心、基于问卷的调查，于 2004 年至 2005 年间进行。建议开始胰岛素治疗的患者 (n = 148) 回答了一份调查问卷，按照 5 分制对 16 条有关胰岛素治疗的陈述的同意程度进行评级（1：非常不同意，5：非常同意）。 1 和 2 的评级被归类为“不同意”声明，3、4 和 5 的评级被归类为“同意”。他们的主治医生（n = 68）选择了可能与患者对胰岛素治疗的担忧相关的陈述。结果：几乎所有患者都同意“我不想在余生中自己注射”（95％）和“我不想为注射而烦恼”（90％）的陈述；不到一半的人同意“我的友谊可能会受到影响”（46%）和“我不明白为什么我需要胰岛素”（45%）。医生的估计和患者报告的实际感受有 13 项陈述存在显着差异。医生似乎特别低估了胰岛素使用的社会方面的影响（例如，“我不想与其他人不同”，55% 的患者与 7% 的医生相比）。相反，“注射是痛苦的”这一说法是医生高估的唯一担忧。结论：事实证明，医生和患者之间对胰岛素治疗的看法存在差异，特别是在社会影响方面。 2004年获得的数据可能无法准确反映目前的情况，但仍然代表了患者和医生普遍认为的胰岛素治疗的障碍。这些结果表明，适当了解患者对胰岛素治疗的担忧对于鼓励及时开始胰岛素治疗非常重要。
Objective: To better understand patient resistance to initiation of insulin therapy, this study examined the perception gap concerning initiation of insulin therapy between individuals with type 2 diabetes and their physicians by using data from the DAWN Japan study.Methods: The DAWN Japan study is a multi-center, questionnaire-based survey, conducted between 2004-2005. Patients recommended to start insulin therapy (n = 148) answered a questionnaire by rating degree of agreement with 16 statements concerning insulin therapy on a 5-point scale (1: strongly disagree to 5: strongly agree). Ratings of 1 and 2 were categorized as 'disagree' with a statement, and 3, 4, and 5 as 'agree'. Their attending physicians (n = 68) selected statements which could be associated with patient's concerns about insulin therapy.Results: Nearly all the patients agreed with the statements 'I don't want to inject myself for the rest of my life' (95%), and 'I don't want to be bothered with doing injections' (90%); fewer than half agreed with 'My friendships may suffer' (46%), and 'I don't understand why insulin is necessary for me' (45%). Estimation by the physicians and the actual perceptions patients reported differed significantly for 13 statements. Physicians seemed to particularly under-estimate the impact associated with social aspects of insulin use (e. g., 'I don't want to be different from others', 55% patients vs 7% physicians). On the contrary, the statement 'Injections are painful' was the only concern over-estimated by the physicians.Conclusions: It was demonstrated that differences in perceptions regarding insulin therapy exist between physicians and patients, particularly in terms of social impacts. The data, obtained in 2004, may not precisely reflect the present situation, but still represents a barrier to insulin therapy widely held by patients and physicians. These results suggest that appropriate understanding of patients' concerns about insulin therapy is important to encourage timely insulin initiation.