Barriers and Attitudes of Primary Healthcare Physicians to Insulin Initiation and Intensification in Saudi Arabia

Ali Jaber Alhagawy, Saeed Yafei (), Abdulrahman Hummadi, Raed Abutaleb, Mohammed Hakamy, Turki Alzughbi, Nabeel Gharawi, Manal Moafa, Asma Mokali, Ibrahim Alhiqwy and Mousa Altherwi
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Ali Jaber Alhagawy: Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
Saeed Yafei: Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
Abdulrahman Hummadi: Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
Raed Abutaleb: Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
Mohammed Hakamy: Family Medicine, Jazan Health Affairs, Ministry of Health, Jazan 45142, Saudi Arabia
Turki Alzughbi: Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
Nabeel Gharawi: Family Medicine, Jazan Health Affairs, Ministry of Health, Jazan 45142, Saudi Arabia
Manal Moafa: Family Medicine, Jazan Health Affairs, Ministry of Health, Jazan 45142, Saudi Arabia
Asma Mokali: Family Medicine, Jazan Health Affairs, Ministry of Health, Jazan 45142, Saudi Arabia
Ibrahim Alhiqwy: Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
Mousa Altherwi: Nursing Department, Ministry of Health, Jazan 45142, Saudi Arabia

IJERPH, 2022, vol. 19, issue 24, 1-9

Abstract: Saudi Arabia is a country with high prevalence of diabetes, uncontrolled diabetes, and diabetes-related complications. Poor glycemic control is multifactorial and could be explained in part by physician and patient reluctance toward insulin or insulin inertia. This study aimed to address physician barriers toward insulin therapy in primary care settings. It included 288 physicians from 168 primary healthcare centers (PHC) in the Jazan region of Saudi Arabia. Participants responded to questionnaire investigating physicians’ attitude and barriers to insulin initiation and intensification in PHCs. In physician opinion, the most common barriers among their patients were fear of injection, lack of patient education, fear of hypoglycemia, and difficult administration. Physicians were reluctant to initiate insulin for T2D patients mostly due to patient non-adherence to blood sugar measurement, non-adherence to appointment or treatment, elderly patients, or due to patient refusal. Physicians’ fear of hypoglycemia, lack of staff for patient education, and lack of updated knowledge were the primary clinician-related barriers. Exaggerated fears of insulin side effects, patient non-adherence, limited staff for patient’s education, patient refusal, and inadequate consultation time were the main barriers to insulin acceptance and prescription.

Keywords: clinical inertia; therapeutic inertia; insulin initiation; type 2 diabetes; primary healthcare physicians; barriers (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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