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Gaceta médica de México
versión On-line ISSN 2696-1288versión impresa ISSN 0016-3813
Resumen
VAZQUEZ, Felipe; LAVIELLE, Pilar; GOMEZ-DIAZ, Rita y WACHER, Niels. Inercia clínica en el tratamiento con insulina en el primer nivel de atención. Gac. Méd. Méx [online]. 2019, vol.155, n.2, pp.156-161. Epub 01-Jul-2021. ISSN 2696-1288. https://doi.org/10.24875/gmm.19004582.
Introduction:
Refusal of physicians to prescribe insulin to their patients has been scarcely evaluated; the delay in treatment intensification hinders adequate and quality care.
Objective:
To identify the perception of primary care physicians about barriers to initiate insulin treatment in patients with diabetes.
Method:
Using the Smith Index and multivariate analysis, the relevance and grouping of concepts related to barriers to insulin prescription were assessed in 81 family doctors.
Results:
Only 35.8% of physicians showed confidence for prescribing insulin; almost half of them rated treatment intensification between moderately and little important (39.5% and 6.2%). Barriers were related to the physician (39.5%), the patient (37%), insulin treatment (11.1%) and the institution (6.2%); 6.2 % of physicians did not perceive any barrier. The barriers were grouped in 5 factors that explained 62.48% of the variance: patient cultural level, lack of medical skills, fear of adverse events, insecurity and lack of training.
Conclusion:
Clinical inertia was not the result of a complex medical condition or patient comorbidities, but of doctors perception and confidence in his/her clinical and communication skills.
Palabras llave : Clinical inertia; Primary care; Insulin treatment; Barriers.