Insulin Administration and the Impacts of Forgetting a Dose

Brod, Meryl; Pohlman, Betsy; Kongsø, Jens Harald

doi:10.1007/s40271-013-0029-9

Cited by 16 publications

(17 citation statements)

References 7 publications

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“…This is in line with a major concerns highlighted by patients (e.g. [3]): remembering what medication has been taken.…”

Section: Tablets)supporting

confidence: 84%

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The minimal effective dose of reminder technology

Wolters

2014

CHI '14 Extended Abstracts on Human Factors in Computing Systems

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Remembering to take one's medication on time is hard work. This is true for younger people with no chronic illness as well as older people with many co-morbid conditions that require a complex medication regime. Many technological solutions have been proposed to help with this problem, but is more IT really the solution? In this paper, I argue that technological help should be limited to the minimal effective dose, which depends on the person and their living situation, and may well be zero.

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“…This is in line with a major concerns highlighted by patients (e.g. [3]): remembering what medication has been taken.…”

Section: Tablets)supporting

confidence: 84%

“…Taking medications is not just hard work for people who self-manage chronic health conditions [11,9,10,3], it is hard work for everybody.…”

Section: The Work Of Taking Medicationsmentioning

confidence: 99%

The minimal effective dose of reminder technology

Wolters

2014

CHI '14 Extended Abstracts on Human Factors in Computing Systems

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“…The inherent complexities of managing insulin, was often an impediment to insulin adherence in several surveys [ 48 , 50 , 62 , 63 ] which reported associations between insulin non-adherence and practical barriers, injection difficulties and regimen inflexibility. Patients remembering whether they had taken their insulin was another factor, with people omitting injections if they were unsure whether they had taken it or not: “I am type 2 and when I forget my insulin in the morning, then I skip it and take my next insulin with my next meal.” [Germany, Male] [ 37 ] …”

Section: Resultsmentioning

confidence: 99%

Perceptions of insulin use in type 2 diabetes in primary care: a thematic synthesis

2018

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BackgroundIncreasing numbers of patients with type 2 diabetes mellitus are progressing to insulin therapy, and despite its potency many such individuals still have suboptimal glycaemic control. Insulin initiation and intensification is now often conducted by Practice Nurses and General Practitioners in many parts of the UK. Therefore, gaining insight into perspectives of patients and primary care clinicians is important in determining self-management and engagement with insulin. A thematic synthesis of studies was conducted exploring the views and experiences of people with type 2 diabetes and of healthcare professionals on insulin use and management in the context of primary care.MethodsProtocol based systematic searches of electronic databases (CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and Web of Science) were performed on 1 October 2014 and updated on 31 March 2015, to identify studies that identified the views and experiences of adults with type 2 diabetes or primary care clinicians on the use of insulin in the management of type 2 diabetes. Studies meeting the review inclusion criteria were critically appraised using the CASP qualitative research checklist or Barley’s checklist for survey designs. A thematic synthesis was then conducted of the collected studies.ResultsThirty-four studies were selected. Of these, 12 used qualitative interviews (nine with patients and three with healthcare professionals) and 22 were survey based (14 with patients, three with healthcare professionals, and five with both). Twelve key themes were identified and formed three domains, patient perceptions, healthcare professional perceptions, and health professional-patient relationships. The patient-centred themes were: insulin-related beliefs, social influences, psychological factors, hypoglycaemia, and therapy barriers. The clinician-related themes were: insulin skills of general practitioners, healthcare integration, healthcare professional-perceived barriers, hypoglycaemia, and explanations for adherence. Healthcare professional-patient relationship themes were drawn from the perspectives of patients and from clinicians.ConclusionsThis review reveals multiple barriers to optimal insulin use in primary care at both the patient and healthcare professional levels. These barriers indicate the need for multimodal interventions to: improve the knowledge and competencies of primary care professionals in insulin use; provide more effective patient education and self-management support; and introduce integrated insulin support systems.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0753-2) contains supplementary material, which is available to authorized users.

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“…Our finding that HF patients are uncertain about how to handle this situation is consistent with those of others who found that worrying and uncertainty were common in adults with diabetes experiencing insulin dosing problems. 31 Handling a missed dose is clearly a situational skill that needs to be emphasized in teaching sessions.…”

Section: Discussionmentioning

confidence: 99%