Issues Affecting Medication-Taking Behavior of People with Type 2 Diabetes in Indonesia: A Qualitative Study

Widayanti, Anna Wahyuni; Sigalingging, Kristian Kalvin; Dewi, Furi Patriana; Widyakusuma, Niken Nur

doi:10.2147/ppa.s301501

Cited by 2 publications

(3 citation statements)

References 44 publications

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“…Thus, these conditions become an out-of-pocket expense for patients. 6 , 7 These issues are related to needle prescription regulation in Indonesia according to the experts. The lack of clear regulation on needle prescription in Indonesia has impacted injection technique and the effectiveness of the drug, besides the length of the needle is related to proper injection technique.…”

Section: Implementing Proper Injection Techniques and Improved Needle...mentioning

confidence: 99%

“…This was evident in Nias Island, where most of the patients experienced poor glycemic control, despite relying on insulin, which is associated with non-adherence to treatment and may lead to diabetes complications. 7 In Nias Island, frequent storms disrupted insulin supply, and the temperature monitor was not functional, highlighting the importance of regulating cold-chain management. The government and pharmacies are responsible for maintaining cold-chain management and insulin supply at healthcare facilities through JKN.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, other issues related to insulin use in Indonesia are the improper injection technique and repeated use of needles, resulting in pain for PWD. 7 …”

Section: Introductionmentioning

confidence: 99%

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Expert Opinion on Addressing the Gap in Injection Technique and Needle Reuse for People with Diabetes in Indonesia

Soewondo,

Suastika,

Kshanti

et al. 2023

DMSO

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The use of insulin for patients with diabetes mellitus in Indonesia appears to be under expectation; moreover, there are gaps in knowledge regarding the proper injection technique and pen needle reuse by both healthcare professionals (HCPs) and patients. To address these issues, a scientific expert meeting was held with the participation of endocrinologists and public health specialist from many different organizations in Indonesia to identify the challenges and problem related to injection technique, high pen needle reuse rate, and the need of all stakeholders. The experts agreed that it is necessary to ensure physicians to start the initiation phase as early as indicated, continue optimizing its dosage to reach targeted blood sugar based on guideline, and involve all relevant stakeholders to improve insulin distribution and patient access in every primary care facility in order to optimize the use of insulin or other injectable diabetes medications in Indonesia. Additionally, the experts believed that education on proper injection technique and improved reuse rate of pen needle is necessary. To date, Indonesian Diabetes Educators Association (IDEA/PEDI) has established guideline on injection technique. There are also recommendations on injection technique and needle reuse from Indonesian Society of Endocrinology (PERKENI) and Forum for Injection Technique & Therapy: Expert Recommendations (FITTER); however, this guideline/recommendation should be disseminated more widely among HCPs. In addition, cost-effectiveness studies based on local data are needed to propose and convince the Payors and other stakeholders. This article can be used as a guidance for HCPs and policymakers to improve current practice on injection technique, pen needle reuse, needle prescription and reimbursement policy in Indonesia and elsewhere.

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Section: Implementing Proper Injection Techniques and Improved Needle...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Expert Opinion on Addressing the Gap in Injection Technique and Needle Reuse for People with Diabetes in Indonesia

Soewondo,

Suastika,

Kshanti

et al. 2023

DMSO

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Impact of Syringe and Needle Reuse on the Clinical Outcomes of Patients With Type 2 Diabetes: A 12-Week Randomized Clinical Trial

Berlanda,

Telo,

Gossenheimer

et al. 2024

Diabetes Care

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OBJECTIVE To evaluate the clinical and laboratory outcomes of patients with type 2 diabetes by comparing the no reuse or reuse of syringes and needles for insulin injection. RESEARCH DESIGN AND METHODS Adults with type 2 diabetes who had reused syringes and needles at least three times were randomly instructed either to not reuse or to reuse insulin syringes and needles five times. The primary outcomes assessed were glycemic control, pain scores, and skin complications (ecchymosis, lipohypertrophy, nodules, infection) at baseline and 4, 8, and 12 weeks after the intervention. Secondary outcomes included treatment adherence, quality of life, microbiological contamination of syringes and needles, needle quality, and insulin injection technique. RESULTS Among the 71 participants (mean ± SD age 59.7 ± 8.8 years), 59% were women with a median duration of diabetes of 18 years (interquartile range 10–25 years) and a mean BMI of 31.7 ± 6.7 kg/m2. The group that reused syringes and needles experienced an increase in lipohypertrophy/nodules (0.16 ± 0.08, P = 0.040) but did not experience worsening pain or glycemic control, even when the syringes and needles were inserted into the skin with great effort. There was no difference in the total number of skin complications, quality of life, or microbiological contamination. Both groups improved treatment adherence, with a greater increase in the reuse group. CONCLUSIONS The reuse of syringes and needles is associated with a modest increase in lipohypertrophy/nodules but does not have a short-term impact on glycemic control in patients with type 2 diabetes.

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Issues Affecting Medication-Taking Behavior of People with Type 2 Diabetes in Indonesia: A Qualitative Study

Cited by 2 publications

References 44 publications

Expert Opinion on Addressing the Gap in Injection Technique and Needle Reuse for People with Diabetes in Indonesia

Expert Opinion on Addressing the Gap in Injection Technique and Needle Reuse for People with Diabetes in Indonesia

Impact of Syringe and Needle Reuse on the Clinical Outcomes of Patients With Type 2 Diabetes: A 12-Week Randomized Clinical Trial

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