Charles Grafton Taylor1, Gordon Taylor2, Anique Atherley3, Ian Hambleton4, Nigel Unwin5, Oswald Peter Adams6. 1. Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, St. Michael, Barbados. 2. Department for Health, University of Bath, 1 West 5.115, Claverton Down, BA2 7AY, United Kingdom. Electronic address: g.j.taylor@bath.ac.uk. 3. Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, St. Michael, Barbados. Electronic address: anique.atherley@gmail.com. 4. Chronic Disease Research Centre, University of the West Indies, Cave Hill, Barbados. Electronic address: ian.hambleton@cavehill.uwi.edu. 5. Chronic Disease Research Centre, University of the West Indies, Cave Hill, Barbados. Electronic address: nigel.unwin@cavehill.uwi.edu. 6. Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, St. Michael, Barbados. Electronic address: peter.adams@cavehill.uwi.edu.
Abstract
AIMS: With regards to insulin initiation in Barbados we explored primary care doctor (PCD) perception, healthcare system factors and predictors of PCD reluctance to initiate insulin. METHODS: PCDs completed a questionnaire based on the theory of planned behaviour (TPB) and a reluctance to initiate insulin scale. Using linear regression, we explored the association between TPB domains and the reluctance to initiate insulin scale. RESULTS: Of 161 PCDs, 70% responded (75 private and 37 public sector). The majority felt initiating insulin was uncomplicated (68%) and there was benefit if used before complications developed (68%), but would not use it until absolutely necessary (58%). More private than public sector PCDs (p<0.05) thought that the healthcare system allowed enough flexibility of time for education (68 vs 38%) and initiating insulin was easy (63 vs 35%), but less thought system changes would help initiating insulin (42 vs 70%). Reasons for reluctance to initiate insulin included patient nonadherence (83%) and reluctance (63%). Only the attitudes and belief domain of the TPB was associated with the reluctance to initiate insulin scale (p<0.001). CONCLUSIONS: Interventions focusing on PCD attitudes and beliefs and restructuring services inclusive of the use of diabetes specialist nurses are required.
AIMS: With regards to insulin initiation in Barbados we explored primary care doctor (PCD) perception, healthcare system factors and predictors of PCD reluctance to initiate insulin. METHODS: PCDs completed a questionnaire based on the theory of planned behaviour (TPB) and a reluctance to initiate insulin scale. Using linear regression, we explored the association between TPB domains and the reluctance to initiate insulin scale. RESULTS: Of 161 PCDs, 70% responded (75 private and 37 public sector). The majority felt initiating insulin was uncomplicated (68%) and there was benefit if used before complications developed (68%), but would not use it until absolutely necessary (58%). More private than public sector PCDs (p<0.05) thought that the healthcare system allowed enough flexibility of time for education (68 vs 38%) and initiating insulin was easy (63 vs 35%), but less thought system changes would help initiating insulin (42 vs 70%). Reasons for reluctance to initiate insulin included patient nonadherence (83%) and reluctance (63%). Only the attitudes and belief domain of the TPB was associated with the reluctance to initiate insulin scale (p<0.001). CONCLUSIONS: Interventions focusing on PCD attitudes and beliefs and restructuring services inclusive of the use of diabetes specialist nurses are required.
Authors: Charles G Taylor; Gordon Taylor; Anique Atherley; Ian Hambleton; Nigel Unwin; O Peter Adams Journal: J Clin Transl Endocrinol Date: 2017-05-04