Campbell, Matthew D. and Babic, Drazen and Bolcina, Uros and Smirčić-Duvnjak, Lea and Tankova, Tsvetalina and Mitrakou, Asimina and Kempler, Peter and Janez, Andrej (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
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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 influence clinical decision-making regarding insulin initiation in T2D. ------ Methods: A cross-sectional survey sampled 211 specialist diabetes healthcare prescribers from five Central and South-Eastern European countries (Bulgaria, Croatia, Greece, Hungary, and Slovenia). A structured questionnaire was developed which surveyed current clinical practices and influencing 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.
| Item Type: | Article | ||||||||||||||||||
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| Additional Information: | 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. | ||||||||||||||||||
| MeSH: | Adult ; Attitude of Health Personnel ; Bulgaria / epidemiology ; Croatia / epidemiology ; Cross-Sectional Studies ; Decision Making ; Diabetes Mellitus, Type 2 / drug therapy ; Diabetes Mellitus, Type 2 / epidemiology ; Europe, Eastern / epidemiology ; Female ; Greece / epidemiology ; Guideline Adherence / standards ; Guideline Adherence / statistics & numerical data ; Humans ; Hungary / epidemiology ; Insulin / therapeutic use ; Male ; Middle Aged ; Practice Patterns, Physicians' / statistics & numerical data ; Slovenia / epidemiology ; Surveys and Questionnaires ; Time-to-Treatment / statistics & numerical data | ||||||||||||||||||
| Departments: | Katedra za internu medicinu | ||||||||||||||||||
| Depositing User: | Kristina Berketa | ||||||||||||||||||
| Status: | Published | ||||||||||||||||||
| Creators: |
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| Date: | September 2019 | ||||||||||||||||||
| Date Deposited: | 12 Feb 2020 09:47 | ||||||||||||||||||
| Last Modified: | 12 Feb 2020 09:47 | ||||||||||||||||||
| Subjects: | / | ||||||||||||||||||
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| URI: | http://medlib.mef.hr/id/eprint/3568 |
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