Do you assume your patients take their medicine as ordered?

A recent Internet survey of 502 adults in the US found that more than half the respondents intentionally skipped insulin occasionally, and 20% did not take their insulin regularly. Others may take their insulin, but in a dose smaller than needed for optimal glucose control.

The study discussed the importance of identifying patients who intentionally omit their insulin often. Once you know who they are, you can find out why they are choosing not to take their insulin and coach them toward making healthier choices.

The researchers found that those with a higher household income were less likely to skip doses. This may be because they have better access to medication and supplies, better access to diabetes education, better problem-solving skills, or greater control over their life routines.

Think about it. One in five of your diabetic patients may be regularly skipping insulin. How do you respond to a high A1C? By adjusting the insulin dose? Instead, you might start by asking how things are going financially. This study found lack of personal resources, especially income, is a potential warning sign of insulin omission.

Teaching the newly diagnosed diabetic about diet, testing blood sugars, and administration of insulin is just the start of their patient education. Once they master the information and skills, we need to help them apply those skills to life, and maintain healthy habits. The best way to improve health outcomes is to improve self-care behaviors through information, skills, and health coaching over time.

Resource: Peyrot, M., Rubin, R. R., Kruger, D. F., & Travis, L. B. (2010). Correlates of Insulin Injection Omission. Diabetes Care, 22, 240-245.

2 Responses to “Do you assume your patients take their medicine as ordered?”

1. Nita Pyle says:

   February 5, 2010 at 9:44 am

   At our institution, the Patient Education Office has embarked on an evidence based project “What communication strategies are most effective with cancer patients in increasing their oral chemotherapy treatment adherence? Thanks for the article.
2. NoTime_author says:

   February 6, 2010 at 8:25 pm

   Nita, when your project is complete, please post your findings here!