Barriers to insulin initiation: the translating research into action for diabetes insulin starts project.
Barriers to insulin initiation: the translating research into action for diabetes insulin starts project.
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DOI：
10.2337/dc09-1184
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发表时间：
2010-04
期刊：
影响因子：
16.2
通讯作者：
Marrero DG
中科院分区：
文献类型：
--
作者：
Karter AJ;Subramanian U;Saha C;Crosson JC;Parker MM;Swain BE;Moffet HH;Marrero DG
未能开始使用处方胰岛素（原发性不依从）的原因尚不清楚。我们调查了新处方后开始胰岛素治疗的障碍。我们调查了胰岛素初治的2型糖尿病控制不佳的患者，他们已经接受了两种或更多种口服药物的治疗，并且最近接受了胰岛素处方。我们比较了应答者处方，但从未开始，胰岛素（n = 69）与那些分发胰岛素（n = 100）。未能开始使用处方胰岛素的受试者通常报告对胰岛素风险的误解（35%的人认为胰岛素会导致失明、肾衰竭、截肢、心脏病发作、中风或早逝），计划在行为目标、个人失败感、自我效能感低、注射恐惧症、低血糖担忧、对社会生活和工作的负面影响、健康素养不足、医疗保健提供者未充分解释风险/益处，胰岛素自我管理培训有限。通过更好地与提供者沟通风险、共同决策和胰岛素自我管理培训，可以提高胰岛素的主要依从性。
Reasons for failing to initiate prescribed insulin (primary nonadherence) are poorly understood. We investigated barriers to insulin initiation following a new prescription. 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). 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. 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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影响因子：
16.2
作者：
Polonsky, WH;Fisher, L;Edelman, SV
通讯作者：
Edelman, SV
影响因子：
--
作者：
Schillinger, D;Piette, J;Bindman, AB
通讯作者：
Bindman, AB
影响因子：
120.7
作者：
Turner, RC;Cull, CA;Holman, RR
通讯作者：
Holman, RR
影响因子：
3.9
作者：
Polonsky, William
通讯作者：
Polonsky, William
影响因子：
158.5
作者：
Holman, Rury R.;Thorne, Kerensa I.;Levy, Jonathan C.
通讯作者：
Levy, Jonathan C.