ABSTRACT
OBJETIVO: Analizar el grado de conocimiento y manejo actual de la insulinización por los médicos de atención primaria (AP), así como su impacto sobre el grado de control metabólico. MATERIALES Y MÉTODOS: Estudio secuencial exploratorio, principalmente cualitativo con un enfoque fenomenológico y posterior fase cuantitativa. Participaron 37 médicos de AP del Servicio Andaluz de Salud. Se realizó análisis univariado y bivariado de variables sociodemográficas y clínico-asistenciales. RESULTADOS: Existió una gran variabilidad entre los médicos de AP acerca del conocimiento sobre el tratamiento con insulinas (conocimiento bajo: 13,5%; medio: 59,5%; alto: 27,0%). Hubo una relación directa entre el conocimiento sobre insulinización y el grado de consecución de objetivos de HbA1c: a mayor grado de conocimiento, mejor control metabólico. Las insulinas basales más prescritas fueron la insulina glargina100 (56,8%), seguida de la insulina glargina300 (29,7%) y después la insulina NPH (8,1%). Hubo tendencia a presentar un diferente perfil de prescripción respecto a las insulinas basales, de tal forma que la prescripción de insulina NPH y de insulinas mixtas coincidía con el nivel más bajo de conocimiento. El 35,1% de los médicos de AP desconocían patrones de insulinización más complejos. CONCLUSIONES: Solo el 27% de los médicos de AP tienen un conocimiento elevado sobre el tratamiento con insulinas. Existe una relación directa entre el nivel de conocimiento sobre las insulinas y el grado de control glucémico. Es necesario mejorar el conocimiento sobre el tratamiento con insulinas para optimizar el control metabólico y disminuir el riesgo de complicaciones
OBJECTIVE: To determine the level of knowledge and current management of starting insulin treatment by Primary Care physicians, and its impact on metabolic control. MATERIALS AND METHODS: A mainly qualitative exploratory sequential study, with a phenomenological approach, followed by a quantitative phase. The study included 37 primary care physicians from the Andalusian Health Service. Socio-demographic and clinical care variables were analysed. Univariate and bivariate analyses were performed. RESULTS: There was a wide variability between Primary Care physicians in the level of knowledge of treatment with insulins (low knowledge: 13.5%; medium knowledge: 59.5%; high knowledge: 27.0%). There was a direct relationship between the level of knowledge and the attainment of HbA1c goals (as the level of knowledge increased, the metabolic control improved). The most common basal insulins prescribed were insulin glargine U-100 (56.8%), followed by insulin glargine U-300 (29.7%), and neutral protamine hagedorn (NPH) insulin (8.1%). There was a trend to show a different prescription pattern with basal insulins (as the level of knowledge decreased, the prescription of mixed and NPH insulins increased). More than one-third (35.1%) of primary care physicians did not know more complex patterns of treatment with insulins. CONCLUSIONS: Only 27% of Primary Care physicians had a high knowledge about treatment with insulins. There was a direct relationship between the level of knowledge about insulins and glycaemic control. It is necessary to improve the knowledge about insulin therapy in order to optimise metabolic control and reduce the risk of complications
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Insulin/administration & dosage , Hyperglycemia/prevention & control , Diabetes Mellitus/drug therapy , Medication Therapy Management/organization & administration , Health Knowledge, Attitudes, Practice , Health Care Surveys/statistics & numerical data , Diabetes Mellitus/prevention & control , Primary Health Care , Time-to-Treatment/organization & administration , Hypoglycemic Agents/therapeutic useABSTRACT
OBJECTIVE: To determine the level of knowledge and current management of starting insulin treatment by Primary Care physicians, and its impact on metabolic control. MATERIALS AND METHODS: A mainly qualitative exploratory sequential study, with a phenomenological approach, followed by a quantitative phase. The study included 37 primary care physicians from the Andalusian Health Service. Socio-demographic and clinical care variables were analysed. Univariate and bivariate analyses were performed. RESULTS: There was a wide variability between Primary Care physicians in the level of knowledge of treatment with insulins (low knowledge: 13.5%; medium knowledge: 59.5%; high knowledge: 27.0%). There was a direct relationship between the level of knowledge and the attainment of HbA1c goals (as the level of knowledge increased, the metabolic control improved). The most common basal insulins prescribed were insulin glargine U-100 (56.8%), followed by insulin glargine U-300 (29.7%), and neutral protamine hagedorn (NPH) insulin (8.1%). There was a trend to show a different prescription pattern with basal insulins (as the level of knowledge decreased, the prescription of mixed and NPH insulins increased). More than one-third (35.1%) of primary care physicians did not know more complex patterns of treatment with insulins. CONCLUSIONS: Only 27% of Primary Care physicians had a high knowledge about treatment with insulins. There was a direct relationship between the level of knowledge about insulins and glycaemic control. It is necessary to improve the knowledge about insulin therapy in order to optimise metabolic control and reduce the risk of complications.
