Assessment of diabetic patients' adherence to insulin injections on basal-bolus regimen in diabetic care center in Saudi Arabia 2018: Cross sectional survey

Abstract

Background: Since insulin became a focal point of diabetes management, several studies have been carried out to monitor and improve patient outcomes. Adherence insulin therapy is an important part of diabetes management. Aim: This study reviews the responses of patients being managed in a diabetic care setting in monitoring their adherence to basal bolus insulin therapy. Method: A pre-validated questionnaire containing 18 questions was administered to patients in the diabetic care unit of the Security Forces Hospital, Riyadh, Saudi Arabia. Results: The levels of adherence with basal bolus insulin therapy was 61.9%. There is no considerable difference in adherence levels of male and female respondents with 31.62% and 31.58% respectively. The younger age groups (14-29) had the highest adherence levels at 65.75%. Higher levels of patient literacy and the location also have a positive relationship with adherence. Conclusion: To improve adherence levels, dosing should be made with consideration for patient convenience, and patients should be encouraged to build positive psychological relationships. Further studies should look to studying outcomes of therapy, and markers should be developed to monitor patient progress on therapy regimen regularly. The aspect of short clinic visits is another major consideration that needs to be look into properly to understand and monitor patients’ proper adherence toward the basal bolus insulin.

Assessment of Adherence to Insulin Injections among Diabetic Patients on Basal-Bolus Regimen in Primary and Secondary Healthcare Centers in Al-Jouf Region of Saudi Arabia; A Descriptive Analysis

“…Since the burden of diabetes mellitus is linked with its control, which is directly related to adherence, nonadherence should be considered a significant health concern of priority [13]. Our study indicated that 40.7% of diabetic patients forget to take insulin doses every week.…”

“…Section V had items related to the factors that may increase the adherence of insulin injections, and the participants were asked to select the factors according to their understanding. A similar type of questionnaire has been used in the literature [13]. The questionnaire was translated from English to Arabic through a forward-and-backward translation process.…”

“…Several studies from Saudi Arabia have enumerated various factors affecting adherence to the treatment of DM, including male gender, fear of injection, fear of hypoglycemia, injection site reactions, and poor self-administration technique of insulin due to the lack of adequate knowledge [11,12]. A cross-sectional survey on adherence to the insulin injection showed that only 61.9% of the patients adhered to the therapy, where a higher level of adherence was observed in young people aged 14 to 29 years [13]. A study from Ethiopia showed that only one-fourth (24.2%) of the participants were adherent to their insulin therapy [10].…”

One in Seven Insulin-Treated Patients in Developing Countries Reported Poor Persistence with Insulin Therapy: Real World Evidence from the Cross-Sectional International Diabetes Management Practices Study (IDMPS)

“…In previous IDMPS waves, we have reported the independent and positive association of high levels of education and access to diabetes education with SMBG, self-titration of insulin and glycaemic control in both patients with T1D or T2D [ 17 ]. In Saudi Arabia and Cameroon, patient literacy was closely associated with adherence to therapies [ 33 , 34 ]. Low education level and poverty have been associated with increased incidence of all-cause and cardiovascular mortality in patients with diabetes after adjusting for confounders [ 35 , 36 ].…”

Assessment of Insulin Injection Technique Among Diabetic Patients in Makkah Region in Saudi Arabia

“…Factors associated with reduced insulin adherence include smoking, young age, low socioeconomic status, level of scholarship, presence of other comorbidities, and polypharmacy [ 19 ]. In our study, only the frequency of administration exhibited a significant difference in practices toward insulin injection (p = 0.049); patients who administered insulin injection three times daily had the best practices toward insulin injection when compared to other patients.…”