Prevalence of Primary Non-adherence with Insulin and Barriers to Insulin Initiation in Patients with Type 2 Diabetes Mellitus – An Exploratory Study in a Tertiary Care Teaching Public Hospital

Sharma, Suresh K; Kant, Ravi; Kalra, Sanjay; Bishnoi, Ravin Kumar

doi:10.17925/ee.2020.16.2.143

Cited by 10 publications

(11 citation statements)

References 21 publications

(23 reference statements)

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“…Among patients receiving insulin, 6/240 (3%) scored ≥ 3 on items “I am afraid of injecting myself” and “I’m afraid to prick my finger” using the Barriers to Diabetes Questionnaire, indicating “serious problems” with needles [ 47 ]. A study utilising face-face interviews examined the prevalence of primary non-adherence with insulin and barriers to insulin initiation in patients with type 2 diabetes [ 51 ]. This study revealed that 47% (105/225) delayed insulin treatment.…”

Section: Resultsmentioning

confidence: 99%

“…However, a variety of other assessment methods were used including psychometric self-report tools [ 25 , 26 , 35 , 39 ], investigator-created surveys [ 1 , 28 , 30 , 41 , 50 , 52 ], and face-to-face interviews [ 2 , 33 , 40 ]. Moreover, needle phobia was determined by single or multiple items on self-report measures [ 2 , 24 , 28 , 51 ], not formal diagnostic assessment.…”

Section: Discussionmentioning

confidence: 99%

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The prevalence and evidence-based management of needle fear in adults with chronic disease: A scoping review

et al. 2021

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Background Little is known about the prevalence and best management of needle fear in adults with chronic disease, who may experience frequent and long-term exposure to needles for lifesaving therapies such as renal dialysis and cancer treatment. Identifying interventions that assist in management of needle fear and associated distress is essential to support these patients with repeated needle and cannula exposure. Method We followed the PRISMA methodology for scoping reviews and systematically searched PsychINFO, PubMed (MEDLINE), ProQuest, Embase and grey literature and reference lists between 1989 and October 2020 for articles related to needle discomfort, distress, anxiety, fear or phobia. The following chronic diseases were included: arthritis, asthma, chronic back pain, cancer, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and mental illness, or kidney failure. Literature concerning dentistry, vaccination, intravenous drug users and paediatric populations were excluded. Results We identified 32 papers reporting prevalence (n = 24), management (n = 5) or both (n = 3). Needle fear prevalence varied in disease cohorts: 17–52% (cancer), 25–47% (chronic kidney disease) and 0.2–80% (diabetes). Assessment methods varied across studies. Management strategies had poor evidence-base, but included needle-specific education, decorated devices, cognitive-behavioural stress management techniques, distraction, and changing the therapy environment or modality. Conclusion Although needle fear is common there is a paucity of evidence regarding interventions to address it among adults living with chronic disease. This scoping review has highlighted the need for improved identification of needle fear in adults and development of interventions are required for these cohorts.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The prevalence and evidence-based management of needle fear in adults with chronic disease: A scoping review

et al. 2021

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“…While using a clear and universal definition of needle phobia can benefit clinical practice and research, any level of needle fear is important, considering its significant negative impacts on physical and mental well-being [ 6 , 7 , 9 – 13 ]. Adopting a broad definition may be more inclusive of patients experiencing needle fear in their daily lives, who may not fulfill the criteria for narrow definitions, and could still present risks of avoiding medical care [ 6 , 7 , 10 – 12 ]. Thus, the high prevalence reported in this study may be more representative of the burden needle phobia constitutes in the general adult population.…”

Section: Discussionmentioning

confidence: 99%

“…Second, needle phobia may lead to poor disease prognosis due to poor adherence to treatment. [ 10 ] Because these patients are likely suffering from chronic (e.g., kidney disease) or other severe conditions (e.g., cancer), they may be more vulnerable to needle phobia and its impacts on treatment adherence. Avoidance behavior may have a more significant impact on patients with conditions requiring frequent injections compared to healthier individuals [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, causes, impacts, and management of needle phobia: An international survey of a general adult population

Alsbrooks

Hoerauf²

2022

PLoS ONE

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Needle phobia is an overlooked condition that affects virtually all medical procedures. Our study aimed to identify how commonly needle phobia is experienced, its underlying reasons, impacts, and potential mitigation strategies. A global survey was conducted in a general adult population using a questionnaire based on a targeted literature review that identified under-researched areas. The 21-item questionnaire was completed on a secure, web-based survey platform. Statistical analyses and models were utilized to identify relationships between participant characteristics and needle phobia. Of the 2,098 participants enrolled in the study, 63.2% (n = 1,325) reported experiencing needle phobia, and rated the intensity of their fear as 5.7 (±2.6) on average on a scale from 0 (no fear) to 10 (very strong/unreasonable fear or avoidance). According to the logistic regression model, other medical fears (odds coefficient = 2.14) and family history (1.67) were the most important factors associated with needle phobia. General anxiety (96.1%) and pain (95.5%) were the most common reasons for needle fear. Of the participants experiencing needle phobia, 52.2% stated avoiding blood draws, followed by 49.0% for blood donations, and 33.1% for vaccinations. While 24.3% of participants have seen a therapist, most have never sought help. The majority have shared their fear with nurses (61.1%) or physicians (44.4%); however, the provider helpfulness was rated as 4.9 (±3.1) on average on a scale from 0 (unhelpful) to 10 (extremely helpful). Utilizing non-invasive alternatives (94.1%) and smaller needles (91.1%) were most commonly identified as potential device-related solutions to alleviate fear; distractions (92.1%) and relaxation techniques (91.7%) were the top non-device-related approaches. Our findings highlight the prevalent nature of needle phobia and provide insights into its etiology and effects on patient care. Clinician responses were not perceived as helpful, emphasizing the need to address needle phobia, and improve patient experience.

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“…There are some strong arguments in favour of the benefits of orally administered insulin compared to injections. The numbers of Type II diabetic patients adhering to the SC chronic dosing regimen for insulin is low, estimated as less than 50% (Sharma et al, 2020). Many Type II diabetic patients delay by more than 2 years going onto insulin from when first offered it, while others may adhere to the dosing regimen at the beginning, but then their commitment may wane.…”

Section: The Arguments For Oral Insulin For Diabetic Patientsmentioning

confidence: 99%

The Centenary of the Discovery of Insulin: An Update on the Quest for Oral Delivery

Brayden

2021

Front. Drug. Deliv.

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Not many topics in drug delivery science have exercised so many pharmaceutical, formulation, and bioengineering minds than the oral delivery of macromolecules, especially when insulin is the focus. The year 2021 marks a hundred years since the discovery of insulin by Banting and Best to treat Type 1 diabetes. Repeated efforts to deliver it orally since then have met with failure, with particular disappointment resulting from encouraging preclinical studies in the 1980s. Here, the barriers to synthesizing successful oral inulin formulations are discussed. It is apparent that this peptide has chemistry and pharmacology features that make its oral delivery one of the toughest challenges in delivery science. At this seminal point in its history, the question is whether oral delivery of insulin will ever be possible, or even if this quest is still desirable?

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Prevalence of Primary Non-adherence with Insulin and Barriers to Insulin Initiation in Patients with Type 2 Diabetes Mellitus – An Exploratory Study in a Tertiary Care Teaching Public Hospital

Cited by 10 publications

References 21 publications

The prevalence and evidence-based management of needle fear in adults with chronic disease: A scoping review

The prevalence and evidence-based management of needle fear in adults with chronic disease: A scoping review

Prevalence, causes, impacts, and management of needle phobia: An international survey of a general adult population

The Centenary of the Discovery of Insulin: An Update on the Quest for Oral Delivery

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