Assessing barriers to insulin therapy among people with type 2 diabetes in South Africa using the Insulin Treatment Appraisal Scale : a cross-sectional survey

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dc.contributor.author Ngassa Piotie, Patrick
dc.contributor.author Muchiri, Jane Wanjiku
dc.contributor.author Webb, Elizabeth M.
dc.contributor.author Rheeder, Paul
dc.date.accessioned 2022-08-05T05:00:17Z
dc.date.issued 2022-08
dc.description.abstract AIMS : To assess barriers to insulin therapy among people with type 2 diabetes after adapting the Insulin Treatment Appraisal Scale (ITAS) to the South African context. METHODS : A panel of experts reviewed the original ITAS for clarity and relevance to the South African context. The ITAS was administered to 253 adults with type 2 diabetes attending diabetes outpatient clinics in the Tshwane Metropolitan Municipality. Internal consistency (Cronbach's alpha) was tested and construct validity was examined using exploratory factor analysis (EFA). PIR was appraised in insulin users and non-users. RESULTS : The EFA revealed that the adapted ITAS had a two-factor structure, similar to the original scale, with acceptable internal consistency (α = 0.85). Insulin-using participants had significantly less negative attitudes to insulin therapy than non-users (40.7 ± 7.1 vs. 51.5 ± 11.2, p < 0.001). Compared to participants who used insulin, participants who did not use insulin were afraid of injecting themselves with a needle (71% vs. 11%, p < 0.001) and saw insulin treatment as a sign of worsening diabetes (63% vs. 29%, p < 0.001). CONCLUSIONS : Consistent with previous studies, participants who were not using insulin had more negative beliefs and attitudes towards insulin treatment than those who were already using insulin. South African clinicians should use the ITAS to assess positive and negative perceptions regarding insulin therapy in both insulin-naïve and insulin-treated people, to evaluate interventions to reduce PIR and improve treatment outcomes. en_US
dc.description.department Human Nutrition en_US
dc.description.department Internal Medicine en_US
dc.description.department School of Health Systems and Public Health (SHSPH) en_US
dc.description.embargo 2023-07-30
dc.description.librarian hj2022 en_US
dc.description.sponsorship The Lilly Global Health Partnership en_US
dc.description.uri http://www.elsevier.com/locate/pcd en_US
dc.identifier.citation Ngassa Piotie, P., Muchiri, J.W., Webb, E.M. et al. 2022, 'Assessing barriers to insulin therapy among people with type 2 diabetes in South Africa using the Insulin Treatment Appraisal Scale : a cross-sectional survey', Primary Care Diabetes, vol. 16, no. 4, pp. 509-514, doi : 10.1016/j.pcd.2022.05.012. en_US
dc.identifier.issn 1751-9918 (print)
dc.identifier.issn 1878-0210 (online)
dc.identifier.other 10.1016/j.pcd.2022.05.012
dc.identifier.uri https://repository.up.ac.za/handle/2263/86716
dc.language.iso en en_US
dc.publisher Elsevier en_US
dc.rights © 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. Notice : this is the author’s version of a work that was accepted for publication in Primary Care Diabetes. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. A definitive version was subsequently published in Primary Care Diabetes, vol. 16, no. 4, pp. 509-514, 2022. doi : 10.1016/j.pcd.2022.05.012. en_US
dc.subject Type 2 diabetes mellitus (T2DM) en_US
dc.subject Insulin therapy en_US
dc.subject Insulin treatment appraisal scale (ITAS) en_US
dc.subject Psychological insulin resistance en_US
dc.title Assessing barriers to insulin therapy among people with type 2 diabetes in South Africa using the Insulin Treatment Appraisal Scale : a cross-sectional survey en_US
dc.type Postprint Article en_US


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