Impact of patients’ beliefs about insulin on acceptance and adherence to insulin therapy: a qualitative study in primary care
Open accessAbstract
Background: Insulin therapy forms a cornerstone of pharmacological management of diabetes mellitus (DM). However, there remains a lack of acceptance and adherence to insulin, thereby contributing to poor DM control. This study aimed to determine the impact of patients’ beliefs about insulin on acceptance and adherence to insulin therapy. Method: This was a qualitative study using grounded theory approach. The study took place from September 2019 to January 2021 at a cluster of primary healthcare clinics in Singapore. Maximum variation sampling was used to recruit adult patients with type 2 DM on basal or premixed insulin for at least 6 months. Semistructured in-depth interviews were conducted using a topic guide and audio recorded. Data collection continued until saturation. Data analysis utilised a constant comparison procedure and a synthesis approach. Results: Twenty-one participants (mean age 61 years) were interviewed for this study. Data analyses showed that there were 6 main themes that emerged. Four themes influenced both insulin acceptance and adherence. These were concerns about insulin being a lifelong treatment, physical fear of insulin injection, erroneous beliefs about insulin, and perceived fear of DM complications. Two additional themes influenced adherence to insulin therapy. These were socioeconomic concerns, and concerns about side effects of insulin. Conclusions: Patients’ beliefs about insulin impact on the acceptance and adherence to insulin therapy. Health care providers need to elicit and address these beliefs during counselling to improve acceptance and adherence to insulin therapy.
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Recent developments have made CGM more available to individuals with diet-controlled diabetes or no diabetes, placing CGM center-stage in efforts to prevent diabetes through lifestyle modifications.
“recent developments have made CGM more available to individuals with diet-controlled diabetes or no diabetes, thereby placing CGM center-stage in efforts to prevent diabetes through lifestyle modifications such as healthier food choices and increased physical activity6,7.”
From Impact of digital health interventions on glycemic control and weight management. (2025) · cites this paper as [6]
The Introduction discusses lifestyle factors in type 2 diabetes, and the Methods describe a study of patients using insulin. Neither those passages nor searches for CGM, continuous glucose monitoring, and diabetes prevention address CGM availability to people with diet-controlled diabetes or no diabetes, or its role in lifestyle-based prevention. (LLM, conf=0.76)
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References 29 · Cited by 33
Research works printed but not linked: 1
- [14]Polit DF CT Beck. essentials of nursing research: appraising evidence for nursing practice 2014 8 Philadelphia Lippincott Williams amp; Wilkins
- Authors
- Liu, C., De Roza, J., Ooi, C. W., Mathew, B. K., Elya, & Tang, W. E.
- Affiliations
- NHG Polyclinics (SG)
- Corresponding author
- Liu, Changwei
- Venue
- BMC Primary Care
- Published
- 2022-01-20
- Volume
- 23
- Issue
- 1
- Pages
- 15-15
- ISSN
- 1471-2296 (ISSN-L)
- 2731-4553
- PMC
- PMC8776322
- OpenAlex
- W4205472133
- Cited by
- 33
- References
- 29
- Citations by year
- 2026: 9 · 2025: 6 · 2024: 6 · 2023: 8 · 2022: 4
- FWCI
- 4.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Family Practice (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Healthcare Group
- Medical Research Council
- National Medical Research Council
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- insulin therapy, type 2 diabetes, patient beliefs, medication adherence, treatment acceptance, patient counseling, primary care
- MeSH terms
- Adult, Diabetes Mellitus, Type 2, Humans, Insulin, Middle Aged, Primary Health Care, Qualitative Research, Insulin, Regular, Human
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