Abstract
Aims
The purpose of this study was to evaluate adherence to insulin therapy in patients
with diabetes. The underlying factors affecting insulin injection omission among patients
with type 1 or 2 diabetes were also investigated.
Methods
This cross-sectional study has been conducted on 507 patients with diabetes. Adherence
to insulin therapy was measured by the 8-Item Moriskey Medication Adherence Scale
(MMS) and the autocompliance method. Furthermore, socio-demographic, disease and injection-related
barriers to insulin injection were assessed.
Results
Based on the Morisky Green test, 14.3% and 28.8% of patients with type 1 and 2 diabetes
respectively had low adherence to insulin therapy. However, almost all patients were
adherent according to the autocompliance method. Different factors showed a significant
association with insulin compliance in both groups.
Conclusions
The current study suggests acceptable adherence to insulin therapy among patients
with type 1, and poor adherence in patients with type 2, diabetes. Our findings regarding
barriers with significant effect on insulin adherence may be useful to identify patients
at risk for low compliance, and to guide the design of proper strategies to improve
adherence and the consequential clinical outcomes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Primary Care DiabetesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Psychometric properties of the Thai version of the 8-item Morisky Medication Adherence Scale in patients with type 2 diabetes.Ann. Pharmacother. 2009; 43: 950-957
- Medication adherence and the associated health-economic impact among patients with type 2 diabetes mellitus converting to insulin pen therapy: an analysis of third-party managed care claims data.Clin. Ther. 2006; 28: 1712-1725
- Type 1 diabetes: new perspectives on disease pathogenesis and treatment.Lancet. 2001; 358: 221-229
- The economic burden of diabetes.Health Affairs. 2010; 29: 297-303
- The economic and clinical benefits of adequate insulin initiation and intensification in people with type 2 diabetes mellitus.Diabetes Obes. Metab. 2012; 14: 47-57
- Adherence to insulin and its association with glycaemic control in patients with type 2 diabetes.QJM. 2007; 100: 345-350
- Barriers to achieving glycemic targets: who omits insulin and why.Diabetes Care. 2010; 33: 450-452
- Correlates of insulin injection omission.Diabetes Care. 2010; 33: 240-245
- The influence of insulin use on glycemic control.Diabetes Care. 2005; 28: 78-83
- Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus.Lancet. 1997; 350: 1505-1510
- Overcoming patient barriers to initiating insulin therapy in type 2 diabetes mellitus.Clin. Cornerstone. 2007; 8: 33-43
- Barriers to insulin injection therapy: patient and health care provider perspectives.Diabetes Educ. 2009; 35: 1014-1022
- Improving patient acceptance and adherence in diabetes management: a focus on insulin therapy.Adv. Ther. 2009; 26: 838-846
- Overcoming barriers to the initiation of insulin therapy.Clin. Diabetes. 2007; 25: 36-38
- Improvement of medication compliance in uncontrolled hypertension.Lancet. 1976; 307: 1265-1268
- A systematic review of adherence with medications for diabetes.Diabetes Care. 2004; 27: 1218-1224
- Psychological insulin resistance: a critical review of the literature.Pract. Diab. Int. 2011; 28: 125-128
- An updated meta-analysis to assess the effectiveness of psychological interventions delivered by psychological specialists and generalist clinicians on glycaemic control and on psychological status.Patient Educ. Couns. 2009; 75: 25-36
- The reality of glycaemic control in insulin treated diabetes: defining the clinical challenges.Int. J. Obes. Relat. Metab. Disord. 2004; 28: S14-S22
- Polypharmacy and medication adherence in patients with type 2 diabetes.Diabetes Care. 2003; 26: 1408-1412
- Recommendations for improving adherence to type 2 diabetes mellitus therapy-focus on optimizing insulin-based therapy.Am. J. Manag. Care. 2012; 18: S55-S61
- Effect of patient medication cost share on adherence and glycemic control.Manag. Care. 2009; 18: 47-53
- Problems paying out-of-pocket medication costs among older adults with diabetes.Diabetes Care. 2004; 27: 384-391
- Barriers to diabetes management: patient and provider factors.Diabetes Res. Clin. Pract. 2011; 93: 1-9
- Real-world factors affecting adherence to insulin therapy in patients with type 1 or type 2 diabetes mellitus: a systematic review.Diabet. Med. 2013; 30: 512-524
- The role of patient–physician trust in moderating medication nonadherence due to cost pressures.Arch. Intern. Med. 2005; 165: 1749-1755
- A conceptually based approach to understanding chronically ill patients’ responses to medication cost pressures.Soc. Sci. Med. 2006; 62: 846-857
- Factors associated with injection omission/non-adherence in the global attitudes of patients and physicians in insulin therapy study.Diabetes Obes. Metab. 2012; https://doi.org/10.1111/j_1463-1326_2012_01636.x
- Hypoglycemia unawareness is associated with reduced adherence to therapeutic decisions in patients with type 1 diabetes: evidence from a clinical audit.Diabetes Care. 2009; 32: 1196-1198
- Improved glycemic control and acute complications among children with type 1 diabetes mellitus in Moshi, Tanzania.Pediatr. Diabetes. 2013; 14: 211-216
- Improved biomedical and psychological outcomes 1 year after structured education in flexible insulin therapy for people with type 1 diabetes: the U.K. DAFNE experience.Diabetes Care. 2012; 35: 1638-1642
- Prediction of the onset of disturbed eating behavior in adolescent girls with type 1 diabetes.Diabetes Care. 2008; 31: 1978-1982
Article info
Publication history
Published online: April 09, 2014
Accepted:
March 13,
2014
Received in revised form:
March 9,
2014
Received:
July 8,
2013
Identification
Copyright
© 2014 Primary Care Diabetes Europe. Published by Elsevier Inc. All rights reserved.
