Identifying solutions to psychological insulin resistance : An international study
Polonsky, William H. (Behavioral Diabetes Institute)
Fisher, Lawrence (University of California. San Francisco)
Hessler, Danielle (University of California. San Francisco)
Stuckey, Heather (Pennsylvania State University)
Snoek, Frank (Amsterdam UMC. University Medical Center)
Tang, Tricia (University of British Columbia)
Hermanns, Norbert (FIDAM GmBH)
Mundet-Tudurí, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina)
Silva, Maria (Instituto Multidisciplinar de Medicina)
Sturt, Jackie (King's College London)
Okazaki, Kentaro (Nagoya University)
Hadjiyianni, Irene (Lilly Deutschland GmbH)
Cao, Dachuang (Eli Lilly and Company)
Ivanova, Jasmina (Analysis Group. Inc.)
Desai, Urvi (Analysis Group. Inc.)
Perez-Nieves, Magaly (Eli Lilly and Company)

Data:	2019
Resum:	Aims: To identify actions of healthcare professionals (HCPs) that facilitate the transition to insulin therapy (IT) in type 2 diabetes (T2D) adults. Methods: Included were T2Ds in seven countries (n = 594) who reported initial IT reluctance but eventually began IT. An online survey included 38 possible HCP actions: T2Ds indicated which may have occurred and their helpfulness. Also reported were delays in IT start after initial recommendation and any period of IT discontinuation. Results: Exploratory factor analysis of HCP actions yielded five factors: "Explained Insulin Benefits" (EIB), "Dispelled Insulin Myths" (DIM), "Demonstrated the Injection Process" (DIP), "Collaborative Style" (CS) and "Authoritarian Style" (AS). Highest levels of helpfulness occurred for DIP, EIB and CS; lowest for AS. Participants who rated DIP as helpful were less likely to delay IT than those who rated DIP as less helpful (OR = 0. 75, p = 0. 01); participants who rated CS and EIB as helpful were less likely to interrupt IT than those who rated these as less helpful (OR = 0. 55, p < 0. 01; OR = 0. 51, p = 0. 01, respectively). Conclusions: Three key HCP actions to facilitate IT initiation were identified as helpful and were associated with more successful initiation and persistence. These findings may aid the development of interventions to address reluctance to initiating IT.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; altres ; Versió publicada
Matèria:	Insulin therapy ; Patient communication ; Perceived helpfulness ; Physician ; Psychological insulin resistance ; Type 2 diabetes
Publicat a:	Journal of Diabetes and its Complications, Vol. 33 Núm. 4 (april 2019) , p. 307-314, ISSN 1873-460X

DOI: 10.1016/j.jdiacomp.2019.01.001
PMID: 30709604

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