Campbell, M orcid.org/0000-0001-5883-5041, Babic, D, Bolcina, U et al. (5 more authors) (2019) High level of clinical inertia in insulin initiation in type 2 diabetes across Central and South-Eastern Europe: Insights from SITIP Study. Acta Diabetologica, 56 (9). pp. 1045-1049. ISSN 0940-5429
Abstract
Aims Little is known regarding initiation of insulin therapy in type 2 diabetes (T2D) in Central and South-Eastern European countries. Therefore, we conducted a survey to characterise the prescribing practices of specialist diabetes healthcare professionals in this region and assessed factors that infuence clinical decision-making regarding insulin initiation in T2D. Methods A cross-sectional survey sampled 211 specialist diabetes healthcare prescribers from fve Central and SouthEastern European countries (Bulgaria, Croatia, Greece, Hungary, and Slovenia). A structured questionnaire was developed which surveyed current clinical practices and infuencing factors, barriers to insulin initiation, and combination therapy prescribing preferences. Result Only 9.4% (20 of out of 211 respondents) of healthcare professionals would initiate insulin therapy in T2D patients at the recommended HbA1c threshold of 7–7.9% [53–63 mmol/mol]. Large regional differences were evident in insulin initiation thresholds (≥9.0% [≥75 mmol/mol]: Bulgaria 80.8% vs. Slovenia 13.3%). Psychological distress was recorded as the major barrier to insulin initiation. Health insurance regulations were ranked more important than personal clinical experience and clinical guidelines in clinical decision-making. Information from peers was more influential than manufacturer information, clinical experience, and continuous medical education, respectively, for insulin initiation. Conclusions Despite large regional variation, there is widespread delay of insulin initiation from specialist diabetes healthcare professionals in Central and South-Eastern Europe.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
Keywords: | Insulin therapy initiation · Type 2 diabetes mellitus · Clinical inertia |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Environment (Leeds) > School of Food Science and Nutrition (Leeds) > FSN Nutrition and Public Health (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 12 Apr 2019 09:31 |
Last Modified: | 25 Jun 2023 21:47 |
Status: | Published |
Publisher: | Springer Milan |
Identification Number: | 10.1007/s00592-019-01346-1 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:144886 |
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