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An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study
OBJECTIVE: Insulin is recommended as an appropriate treatment in type 2 diabetes patients with suboptimal glycemic control; however, its initiation is often delayed. We therefore conducted the DAWN (Diabetes Attitudes, Wishes and Needs) JAPAN study in an attempt to identify specific patient- and phy...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375282/ https://www.ncbi.nlm.nih.gov/pubmed/22719830 http://dx.doi.org/10.1371/journal.pone.0036361 |
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author | Ishii, Hitoshi Iwamoto, Yasuhiko Tajima, Naoko |
author_facet | Ishii, Hitoshi Iwamoto, Yasuhiko Tajima, Naoko |
author_sort | Ishii, Hitoshi |
collection | PubMed |
description | OBJECTIVE: Insulin is recommended as an appropriate treatment in type 2 diabetes patients with suboptimal glycemic control; however, its initiation is often delayed. We therefore conducted the DAWN (Diabetes Attitudes, Wishes and Needs) JAPAN study in an attempt to identify specific patient- and physician-related factors which contribute to delay of insulin initiation among Japanese patients with diabetes. In this report, we explored barriers for physicians which prevent timely insulin initiation. METHODS: The DAWN JAPAN study is a multicenter, questionnaire-based survey, conducted between 2004 and 2005. Participating physicians were categorized as follows based on their expertise: Japan Diabetes Society (JDS) certified specialists (n = 77), JDS-affiliated physicians (n = 30), and non-JDS-affiliated physicians (n = 27). To assess physician barriers to insulin initiation, we have used a newly developed 27- item questionnaire. RESULTS: The mean age of patients (n = 11,656) treated by participating physicians was 64.1 years. The mean duration of diabetes was 121.6 months, and their mean HbA1c was 7.5%. Insulin was used in 27.4% of total patients. With regard to physician barriers to insulin initiation, the biggest differences in concerns expressed by JDS-certified specialists and non-JDS-affiliated physicians were observed in the following items with statistical significance: “I do not have staff (nurse, pharmacists) who can assist with explanations” (1.3% vs 55.5%, respectively), “I have concerns about the use of insulin therapy in elderly patients” (38.1% vs 81.5%), and “It is difficult to provide guidance and education on insulin injection to patients” (16.9% vs 55.5%). The mean HbA1c at which physicians responded they would recommend insulin to their patients was 8.7%; however, they would reduce this level to 8.2% if they themselves required insulin. CONCLUSIONS: Our results demonstrated that physicians have concerns about insulin use, and suggested that their concerns can lead to delay of insulin initiation. |
format | Online Article Text |
id | pubmed-3375282 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-33752822012-06-20 An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study Ishii, Hitoshi Iwamoto, Yasuhiko Tajima, Naoko PLoS One Research Article OBJECTIVE: Insulin is recommended as an appropriate treatment in type 2 diabetes patients with suboptimal glycemic control; however, its initiation is often delayed. We therefore conducted the DAWN (Diabetes Attitudes, Wishes and Needs) JAPAN study in an attempt to identify specific patient- and physician-related factors which contribute to delay of insulin initiation among Japanese patients with diabetes. In this report, we explored barriers for physicians which prevent timely insulin initiation. METHODS: The DAWN JAPAN study is a multicenter, questionnaire-based survey, conducted between 2004 and 2005. Participating physicians were categorized as follows based on their expertise: Japan Diabetes Society (JDS) certified specialists (n = 77), JDS-affiliated physicians (n = 30), and non-JDS-affiliated physicians (n = 27). To assess physician barriers to insulin initiation, we have used a newly developed 27- item questionnaire. RESULTS: The mean age of patients (n = 11,656) treated by participating physicians was 64.1 years. The mean duration of diabetes was 121.6 months, and their mean HbA1c was 7.5%. Insulin was used in 27.4% of total patients. With regard to physician barriers to insulin initiation, the biggest differences in concerns expressed by JDS-certified specialists and non-JDS-affiliated physicians were observed in the following items with statistical significance: “I do not have staff (nurse, pharmacists) who can assist with explanations” (1.3% vs 55.5%, respectively), “I have concerns about the use of insulin therapy in elderly patients” (38.1% vs 81.5%), and “It is difficult to provide guidance and education on insulin injection to patients” (16.9% vs 55.5%). The mean HbA1c at which physicians responded they would recommend insulin to their patients was 8.7%; however, they would reduce this level to 8.2% if they themselves required insulin. CONCLUSIONS: Our results demonstrated that physicians have concerns about insulin use, and suggested that their concerns can lead to delay of insulin initiation. Public Library of Science 2012-06-14 /pmc/articles/PMC3375282/ /pubmed/22719830 http://dx.doi.org/10.1371/journal.pone.0036361 Text en Ishii et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Ishii, Hitoshi Iwamoto, Yasuhiko Tajima, Naoko An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study |
title | An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study |
title_full | An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study |
title_fullStr | An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study |
title_full_unstemmed | An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study |
title_short | An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study |
title_sort | exploration of barriers to insulin initiation for physicians in japan: findings from the diabetes attitudes, wishes and needs (dawn) japan study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375282/ https://www.ncbi.nlm.nih.gov/pubmed/22719830 http://dx.doi.org/10.1371/journal.pone.0036361 |
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