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‘Is Insulin Right for Me?’: Web-based intervention to reduce psychological barriers to insulin therapy among adults with non-insulin-treated type 2 diabetes—A randomised controlled trial
journal contribution
posted on 2023-05-10, 05:40 authored by Elizabeth Holmes-TruscottElizabeth Holmes-Truscott, Edith HollowayEdith Holloway, B Lam, Shaira Baptista, J Furler, Virginia HaggerVirginia Hagger, T Skinner, Jane SpeightJane SpeightAims: To test ‘Is Insulin Right for Me?’, a theory-informed, self-directed, web-based intervention designed to reduce psychological barriers to insulin therapy among adults with type 2 diabetes. Further, to examine resource engagement and associations between minimum engagement and outcomes. Methods: Double-blind, two-arm randomised controlled trial (1:1), comparing the intervention with freely available online information (control). Eligible participants were Australian adults with type 2 diabetes, taking oral diabetes medications, recruited primarily via national diabetes registry. Exclusion criteria: prior use of injectable medicines; being ‘very willing’ to commence insulin. Data collections were completed online at baseline, 2-week and 6-month follow-up. Primary outcome: negative insulin treatment appraisal scale (ITAS) scores; secondary outcomes: positive ITAS scores and hypothetical willingness to start insulin. Analyses: intention-to-treat (ITT); per-protocol (PP) examination of outcomes by engagement. Trial registration: ACTRN12621000191897. Results: No significant ITT between-arm (intervention: n = 233; control: n = 243) differences were observed in primary (2 weeks: Mdiff [95% CI]: −1.0 [−2.9 to 0.9]; 6 months: −0.01 [−1.9 to 1.9]), or secondary outcomes at either follow-up. There was evidence of lower Negative ITAS scores at 2-week, but not 6-month, follow-up among those with minimum intervention engagement (achieved by 44%) compared to no engagement (−2.7 [−5.1 to −0.3]). Conclusions: Compared to existing information, ‘Is insulin right for me?’ did not improve outcomes at either timepoint. Small intervention engagement effects suggest it has potential. Further research is warranted to examine whether effectiveness would be greater in a clinical setting, following timely referral among those for whom insulin is clinically indicated.
History
Journal
Diabetic MedicineArticle number
e15117Pagination
e15117-Location
EnglandPublisher DOI
ISSN
0742-3071eISSN
1464-5491Language
enPublisher
WileyUsage metrics
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Keywords
attitudesinsulininterventionpsychological insulin resistancerandomised control trialtype 2 diabetesDiabetesClinical Trials and Supportive ActivitiesPreventionClinical Research6 Evaluation of treatments and therapeutic interventions6.1 PharmaceuticalsMetabolic and endocrine3 Good Health and Well BeingPublic Health and Health Services not elsewhere classifiedClinical Sciences not elsewhere classifiedPsychology not elsewhere classified
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