ArticleBMC family practice2012
A qualitative study on healthcare professionals' perceived barriers to insulin initiation in a multi-ethnic population.
Article in BMC family practice, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- What are the implications for practice that arise from studies of medication taking? A systematic review of qualitative research.PloS one · 2018Pooled it
- Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Pooled it
- Primary care providers' perspectives on the implementation of couple-based collaborative management for Chinese older adults with type 2 diabetes: a mixed-methods study.Frontiers in public health · 2026Trial
- Insulin therapy refusal among type II diabetes mellitus patients in Kubang Pasu district, the state of Kedah, Malaysia.Singapore medical journal · 2015Trial
- Insulin Prescribing Challenges and Physician-Suggested Interventions: Evidence From a Tertiary Care Hospital in Lahore, Pakistan.Endocrinology, diabetes & metabolism · 2026Article
- Exploring insulin rejection through photo-elicitation among informal caregivers and patients with type 2 diabetes mellitus.Korean journal of family medicine · 2026Article
- Evaluation of the implementation of an insulin patient decision aid for patients with type 2 diabetes in an academic primary care clinic in Malaysia: a mixed method study.BMC health services research · 2025Article
- Conditions for successful implementation of couple-based collaborative management model of diabetes among community-dwelling older Chinese: a qualitative comparative analysis.BMC geriatrics · 2023Article
- Perception and attitude of type 2 diabetic patients toward insulin therapy in the primary care of National Guard for Health Affairs (NGHA) in Jeddah, Saudi Arabia.Journal of family medicine and primary care · 2023Article
- The diabetes insulin self-management education (DIME) intervention for people with type 2 diabetes starting insulin: a pilot feasibility randomised controlled trial.Pilot and feasibility studies · 2023Article
- Article
- Barriers and facilitators to insulin treatment: a phenomenological inquiry.Journal of pharmaceutical policy and practice · 2022Article
- The Role of Religion, Spirituality and Fasting in Coping with Diabetes among Indian Migrants in Australia: A Qualitative Exploratory Study.Journal of religion and health · 2022Article
- Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review.Public health reviews · 2022Article
- Weight Change and the Association with Adherence and Persistence to Diabetes Therapy: A Narrative Review.Patient preference and adherence · 2022Review
- Article
- A qualitative study of clinician attitudes towards closed-loop systems in mainstream diabetes care in England.Diabetic medicine : a journal of the British Diabetic Association · 2020Article
- Who Should Access Closed-Loop Technology? A Qualitative Study of Clinician Attitudes in England.Diabetes technology & therapeutics · 2020Article
- The impact of phenotype, ethnicity and genotype on progression of type 2 diabetes mellitus.Endocrinology, diabetes & metabolism · 2020Review
- Factors influencing implementation of an insulin patient decision aid at public health clinics in Malaysia: A qualitative study.PloS one · 2020Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNationwide surveys have shown that the prevalence of diabetes rates in Malaysia have almost doubled in the past ten years; yet diabetes control remains poor and insulin therapy is underutilized. This study aimed to explore healthcare professionals' views on barriers to starting insulin therapy in people with type 2 diabetes.
methodsHealthcare professionals consisting of general practitioners (n = 11), family medicine specialists (n = 10), medical officers (n = 8), government policy makers (n = 4), diabetes educators (n = 3) and endocrinologists (n = 2) were interviewed. A semi-structured topic guide was used to guide the interviews by trained facilitators. The interviews were transcribed verbatim and analysed using a thematic analysis approach.
resultsInsulin initiation was found to be affected by patient, healthcare professional and system factors. Patients' barriers include culture-specific barriers such as the religious purity of insulin, preferred use of complementary medication and perceived lethality of insulin therapy. Healthcare professionals' barriers include negative attitudes towards insulin therapy and the 'legacy effect' of old insulin guidelines; whilst system barriers highlight the lack of resources, language and communication challenges.
conclusionsTackling the issue of insulin initiation should not only happen during clinical consultations. It requires health education to emphasise the progressive nature of diabetes and the eventuality of insulin therapy at early stage of the illness. Healthcare professionals should be trained how to initiate insulin and communicate effectively with patients from various cultural and religious backgrounds.
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