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dc.contributor.author
Davies, M. J.
dc.contributor.author
Gagliardino, Juan Jose
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dc.contributor.author
Gray, L. J.
dc.contributor.author
Khunti, K.
dc.contributor.author
Mohan, V.
dc.contributor.author
Hughes, R.
dc.date.available
2016-04-22T19:51:46Z
dc.date.issued
2013-03
dc.identifier.citation
Davies, M. J.; Gagliardino, Juan Jose; Gray, L. J.; Khunti, K.; Mohan, V.; et al.; Real-world factors affecting adherence to insulin therapy in patients with Type 1 or Type 2 diabetes mellitus: a systematic review; Wiley; Diabetic Medicine; 30; 5; 3-2013; 512-524
dc.identifier.issn
0742-3071
dc.identifier.uri
http://hdl.handle.net/11336/5340
dc.description.abstract
Aims
To identify real-world factors affecting adherence to insulin therapy in patients with Type 1 or Type 2 diabetes mellitus.
Methods
A literature search was conducted in PubMed and EMBASE in November 2011 to identify studies reporting factors associated with adherence/non-adherence to insulin therapy in adults with Type 1 or Type 2 diabetes.
Results
Seventeen studies were identified; six used self-reported measures and 11 used calculated measures of adherence. Most (13/17) were conducted exclusively in the USA. Four categories of factors associated with non-adherence were identified: predictive factors for non-adherence, patient-perceived barriers to adherence, type of delivery device and cost of medication. For predictive factors and patient-perceived barriers, only age, female sex and travelling were associated with non-adherence in more than one study. Fear of injections and embarrassment of injecting in public were also cited as reasons for non-adherence. Conversely, adherence was improved by initiating therapy with, or switching to, a pen device (in four studies), and by changing to an insurance scheme that lowered the financial burden on patients (in two studies).
Conclusions
Adherence to insulin therapy is generally poor. Few factors or patient-perceived barriers were consistently identified as predictive for non-adherence, although findings collectively suggest that a more flexible regimen may improve adherence. Switching to a pen device and reducing patient co-payments appear to improve adherence. Further real-world studies are warranted, especially in countries other than the USA, to identify factors associated with non-adherence and enable development of strategies to improve adherence to insulin therapy.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Wiley
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dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
Adherence
dc.subject
Insulin Therapy
dc.subject
Type 1 or Type 2 Diabetes
dc.subject
Systematic Review
dc.subject.classification
Endocrinología y Metabolismo
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dc.subject.classification
Medicina Clínica
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dc.subject.classification
CIENCIAS MÉDICAS Y DE LA SALUD
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dc.title
Real-world factors affecting adherence to insulin therapy in patients with Type 1 or Type 2 diabetes mellitus: a systematic review
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2016-05-06 15:52:43.262787-03
dc.journal.volume
30
dc.journal.number
5
dc.journal.pagination
512-524
dc.journal.pais
Estados Unidos
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dc.journal.ciudad
Hoboken
dc.description.fil
Fil: Davies, M. J.. University of Leicester; Reino Unido
dc.description.fil
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
dc.description.fil
Fil: Gray, L. J.. University of Leicester; Reino Unido
dc.description.fil
Fil: Khunti, K.. University of Leicester; Reino Unido
dc.description.fil
Fil: Mohan, V.. Madras Diabetes Research Foundation. Dr Mohan’s Diabetes Specialities Centre; India
dc.description.fil
Fil: Hughes, R.. Oxford PharmaGenesis; Reino Unido
dc.journal.title
Diabetic Medicine
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dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/http://onlinelibrary.wiley.com/doi/10.1111/dme.12128/abstract
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1111/dme.12128
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/10.1111/dme.12128
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