Barriers and Attitudes of Primary Healthcare Physicians to Insulin Initiation and Intensification in Saudi Arabia

Saudi Arabia is a country with high prevalence of diabetes, uncontrolled diabetes, and diabetes-related complications. Poor glycemic control is multifactorial and could be explained in part by physician and patient reluctance toward insulin or insulin inertia. This study aimed to address physician b...

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Bibliographic Details
Published in:International journal of environmental research and public health 2022-12, Vol.19 (24), p.16794
Main Authors: Alhagawy, Ali Jaber, Yafei, Saeed, Hummadi, Abdulrahman, Abutaleb, Raed, Hakamy, Mohammed, Alzughbi, Turki, Gharawi, Nabeel, Moafa, Manal, Mokali, Asma, Alhiqwy, Ibrahim, Altherwi, Mousa
Format: Article
Language:English
Subjects:
Aged
Attitudes
Barriers
Complications
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 2 - epidemiology
Drug dosages
Education
Family physicians
Fear
Fear & phobias
Health care
Health services
Humans
Hypoglycemia
Hypoglycemia - epidemiology
Insulin
Insulin - therapeutic use
Patients
Physicians
Primary care
Primary Health Care
Questionnaires
Saudi Arabia
Social workers
Teachers
Treatment compliance
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Summary:Saudi Arabia is a country with high prevalence of diabetes, uncontrolled diabetes, and diabetes-related complications. Poor glycemic control is multifactorial and could be explained in part by physician and patient reluctance toward insulin or insulin inertia. This study aimed to address physician barriers toward insulin therapy in primary care settings. It included 288 physicians from 168 primary healthcare centers (PHC) in the Jazan region of Saudi Arabia. Participants responded to questionnaire investigating physicians' attitude and barriers to insulin initiation and intensification in PHCs. In physician opinion, the most common barriers among their patients were fear of injection, lack of patient education, fear of hypoglycemia, and difficult administration. Physicians were reluctant to initiate insulin for T2D patients mostly due to patient non-adherence to blood sugar measurement, non-adherence to appointment or treatment, elderly patients, or due to patient refusal. Physicians' fear of hypoglycemia, lack of staff for patient education, and lack of updated knowledge were the primary clinician-related barriers. Exaggerated fears of insulin side effects, patient non-adherence, limited staff for patient's education, patient refusal, and inadequate consultation time were the main barriers to insulin acceptance and prescription.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph192416794