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. 2018 Apr;9(2):713-726.
doi: 10.1007/s13300-018-0389-1. Epub 2018 Mar 8.

Adherence to Insulin, Emotional Distress, and Trust in Physician Among Patients with Diabetes: A Cross-Sectional Study

Lucine Halepian  1   2 , Mary Bou Saleh  1   2 , Souheil Hallit  3   4   5   6   7   8 , Lydia Rabbaa Khabbaz  9   10
Affiliations

Adherence to Insulin, Emotional Distress, and Trust in Physician Among Patients with Diabetes: A Cross-Sectional Study

Lucine Halepian et al. Diabetes Ther. 2018 Apr.

Abstract

Introduction: Type 2 diabetes represents a significant public health issue, with increasing prevalence in developing countries while adherence to insulin treatment remains a challenge. No studies have evaluated the relationship between adherence to insulin, diabetes-related distress, and trust in physician among persons with diabetes. Our objectives were to evaluate treatment adherence to insulin, emotional distress (using the Problem Areas in Diabetes Questionnaire, PAID), trust in physician, and to examine associations between them among Lebanese patients with diabetes.

Methods: This cross-sectional study, conducted in all districts of Lebanon between August 2016 and April 2017, enrolled 135 adult patients.

Results: The mean percentage score of adherence to insulin was 79.7 ± 19.94. A significantly higher mean adherence score was found in non-sedentary (81.96) compared to sedentary patients (67.41) (p = 0.017), with no difference between gender, employment, rural vs non-rural residence, or familial history of diabetes. In addition, no significant relationship was seen between adherence score and education level, smoking, or alcohol intake. A significant positive association was found between trust in physician and adherence scores, whereas a significant but negative one was found between PAID and adherence scores. The results of linear regressions showed that a secondary level of education (beta = - 13.48) significantly decreased the trust in physician score, whereas the total number of oral antidiabetics (beta = 0.93) increased it. Having a sedentary lifestyle (beta = - 12.73) and smoking < 3 waterpipes/week compared to no smoking (beta = - 16.82) significantly decreased the adherence score. Female gender (beta = 10.46), smoking < 3 waterpipes (beta = 27.42) and 3 + waterpipes/week (beta = 17.95) significantly increased the PAID score.

Conclusion: Trust in physician is associated with an increased adherence and with decreased diabetes-related distress. This distress was also associated with poor adherence in our study.

Keywords: Adherence; Diabetes; Emotional distress; Insulin; Trust in physician.

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