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. 2022 Jan 20;23(1):15.
doi: 10.1186/s12875-022-01627-9.

Impact of patients' beliefs about insulin on acceptance and adherence to insulin therapy: a qualitative study in primary care

Changwei Liu  1 , Jacqueline De Roza  2 , Chai Wah Ooi  2 , Blessy Koottappal Mathew  2 , Elya  2 , Wern Ee Tang  2
Affiliations

Impact of patients' beliefs about insulin on acceptance and adherence to insulin therapy: a qualitative study in primary care

Changwei Liu et al. BMC Prim Care. .

Abstract

Background: Insulin therapy forms a cornerstone of pharmacological management of diabetes mellitus (DM). However, there remains a lack of acceptance and adherence to insulin, thereby contributing to poor DM control. This study aimed to determine the impact of patients' beliefs about insulin on acceptance and adherence to insulin therapy.

Method: This was a qualitative study using grounded theory approach. The study took place from September 2019 to January 2021 at a cluster of primary healthcare clinics in Singapore. Maximum variation sampling was used to recruit adult patients with type 2 DM on basal or premixed insulin for at least 6 months. Semistructured in-depth interviews were conducted using a topic guide and audio recorded. Data collection continued until saturation. Data analysis utilised a constant comparison procedure and a synthesis approach.

Results: Twenty-one participants (mean age 61 years) were interviewed for this study. Data analyses showed that there were 6 main themes that emerged. Four themes influenced both insulin acceptance and adherence. These were concerns about insulin being a lifelong treatment, physical fear of insulin injection, erroneous beliefs about insulin, and perceived fear of DM complications. Two additional themes influenced adherence to insulin therapy. These were socioeconomic concerns, and concerns about side effects of insulin.

Conclusions: Patients' beliefs about insulin impact on the acceptance and adherence to insulin therapy. Health care providers need to elicit and address these beliefs during counselling to improve acceptance and adherence to insulin therapy.

Keywords: Beliefs; Diabetes; Insulin adherence.

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Conflict of interest statement

The study authors have no competing interests to declare.

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