Willingness to initiate insulin among adults with type 2 diabetes in Australian primary care: results from the Stepping Up Study

Holmes-Truscott, Elizabeth, Blackberry, Irene, O'Neal, David N., Furler, John S. and Speight, Jane 2016, Willingness to initiate insulin among adults with type 2 diabetes in Australian primary care: results from the Stepping Up Study, Diabetes research and clinical practice, vol. 114, pp. 126-135, doi: 10.1016/j.diabres.2015.12.011.

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Title Willingness to initiate insulin among adults with type 2 diabetes in Australian primary care: results from the Stepping Up Study
Author(s) Holmes-Truscott, ElizabethORCID iD for Holmes-Truscott, Elizabeth orcid.org/0000-0001-9139-4663
Blackberry, Irene
O'Neal, David N.
Furler, John S.
Speight, JaneORCID iD for Speight, Jane orcid.org/0000-0002-1204-6896
Journal name Diabetes research and clinical practice
Volume number 114
Start page 126
End page 135
Total pages 10
Publisher Elsevier
Place of publication Shannon, Ireland
Publication date 2016-04
ISSN 0168-8227
1872-8227
Keyword(s) type 2 diabetes
primary care
insulin therapy
Summary AIMS: To determine 'hypothetical willingness' to initiate insulin, and identify associated factors, among adults with type 2 diabetes (T2DM) in primary care for whom insulin is clinically indicated.

METHODS: Eligible participants were adults with T2DM with an HbA1c ≥7.5% (58mmol/mol) and prescribed maximum oral hypoglycaemic agents. A total of 261 participants were recruited from 74 Victorian general practices: mean age 62±10 years; 39% (n=103) women; diabetes duration 10±6 years; HbA1c 9.0±1.3% (75±14mmol/mol). Data collected by the Stepping Up Study: demographic and clinical characteristics, 'willingness' to initiate insulin, insulin appraisals, depressive symptoms, and diabetes-related distress. A multinomial regression investigated predictors of 'willingness'.

RESULTS: Nineteen percent (n=50) were 'very willing' to initiate insulin, if recommended. The final regression model (R(2)=.44, χ(2)(12) 145.91, p<.001) demonstrated higher socioeconomic status and less negative attitudes to insulin were associated with increased willingness to initiate insulin.

CONCLUSIONS: Among adults with T2DM for whom insulin is clinically indicated, only one in five are 'very willing' to begin insulin therapy. Independent of demographics, clinical factors and emotional wellbeing, insulin appraisals were associated with 'willingness'. This study highlights the importance of addressing attitudinal barriers to insulin therapy among adults with T2DM in primary care to improve insulin receptiveness.
Language eng
DOI 10.1016/j.diabres.2015.12.011
Field of Research 170106 Health, Clinical and Counselling Psychology
1103 Clinical Sciences
Socio Economic Objective 920104 Diabetes
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085263

Document type: Journal Article
Collection: School of Psychology
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