Barriers and Attitudes of Primary Healthcare Physicians to Insulin Initiation and Intensification in Saudi Arabia
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Sampling
2.2. Study Questionnaire
2.3. Statistical Analysis
3. Results
3.1. Physicians Characteristics
3.2. Insulin in the Daily Practice of PCPs
3.3. Barriers to Insulin Initiation and Intensification
3.4. Reasons for Reluctance to Initiate Insulin
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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For Most of My Patients, These Are the Biggest Barrier (s) to Their Acceptance of Insulin Therapy | Total n = 288 | Practitioner n = 202 | Specialist n = 86 | p |
---|---|---|---|---|
Fear of injection | 80.6 | 79.2 | 83.7 | 0.376 |
Lack of education about diabetes and insulin | 68.8 | 69.3 | 67.4 | 0.755 |
Fear of hypoglycemia | 50.7 | 48.5 | 55.8 | 0.257 |
Technical difficulty in insulin administration | 50.7 | 46.5 | 60.5 | 0.030 * |
Concern about personal failure in controlling diabetes | 26.4 | 18.8 | 44.2 | <0.001 * |
Embarrassment/Social Stigma | 16.7 | 14.9 | 20.9 | 0.205 |
Fear of weight gain | 14.6 | 12.9 | 18.6 | 0.207 |
Religious/Cultural Beliefs | 11.1 | 11.9 | 9.3 | 0.524 |
Fear of death | 10.4 | 8.9 | 14 | 0.200 |
Worry about job instability | 8.3 | 5.9 | 14 | 0.024 * |
Decreased Life Span | 6.3 | 2.0 | 16.3 | <0.001 * |
Insulin cost | 4.9 | 4 | 7 | 0.276 |
I May Be Reluctant to Initiate Insulin Therapy for My Patients with T2DM Who | Total n = 288 | Practitioner n = 202 | Specialist n = 86 | p |
Are reluctant to start it | 41.7 | 43.6 | 37.2 | 0.317 |
Do not adhere to their appointments and treatment regimen | 52.1 | 48.5 | 60.5 | 0.063 |
Do not adhere to their self-monitoring of blood sugar | 73.6 | 73.3 | 74.4 | 0.839 |
Are from a low socioeconomic level (poor patient’s cognitive abilities) | 28.5 | 24.8 | 37.2 | 0.032 * |
Are ≥75 years of age because of the risk of hypoglycemia | 51.4 | 50.5 | 53.5 | 0.642 |
Have excess weight (BMI ≥ 35) because of the risk for weight gain | 24.3 | 29.7 | 11.6 | 0.001 * |
Have cardiovascular diseases | 13.9 | 13.9 | 14 | 0.983 |
I may be reluctant to initiate insulin therapy for my patients with T2DM because | ||||
I do not follow the medical updates on insulin therapy | 17 | 17.8 | 15.1 | 0.567 |
I do not have enough experience with insulin therapy | 25.7 | 30.2 | 12.8 | 0.002 * |
I do not have enough time for patient education and training | 28.8 | 29.7 | 26.7 | 0.612 |
I do not have enough staff for patient education and training | 49.3 | 41.6 | 67.4 | <0.001 * |
I worry about the risks of hypoglycemia | 46.5 | 45.5 | 48.8 | 0.608 |
I worry about the risks of weight gain | 13.2 | 12.9 | 14 | 0.804 |
HbA1c is not available for me to guide insulin therapy | 24.8 | 22.4 | 23.9 | 0.638 |
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Alhagawy, A.J.; Yafei, S.; Hummadi, A.; Abutaleb, R.; Hakamy, M.; Alzughbi, T.; Gharawi, N.; Moafa, M.; Mokali, A.; Alhiqwy, I.; et al. Barriers and Attitudes of Primary Healthcare Physicians to Insulin Initiation and Intensification in Saudi Arabia. Int. J. Environ. Res. Public Health 2022, 19, 16794. https://doi.org/10.3390/ijerph192416794
Alhagawy AJ, Yafei S, Hummadi A, Abutaleb R, Hakamy M, Alzughbi T, Gharawi N, Moafa M, Mokali A, Alhiqwy I, et al. Barriers and Attitudes of Primary Healthcare Physicians to Insulin Initiation and Intensification in Saudi Arabia. International Journal of Environmental Research and Public Health. 2022; 19(24):16794. https://doi.org/10.3390/ijerph192416794
Chicago/Turabian StyleAlhagawy, Ali Jaber, Saeed Yafei, Abdulrahman Hummadi, Raed Abutaleb, Mohammed Hakamy, Turki Alzughbi, Nabeel Gharawi, Manal Moafa, Asma Mokali, Ibrahim Alhiqwy, and et al. 2022. "Barriers and Attitudes of Primary Healthcare Physicians to Insulin Initiation and Intensification in Saudi Arabia" International Journal of Environmental Research and Public Health 19, no. 24: 16794. https://doi.org/10.3390/ijerph192416794