Impact of telephonic interviews on persistence and daily adherence to insulin treatment in insulin-na?ve type 2 diabetes patients: dropout study

摘要

Objective: The objective of this study is to evaluate the impact of sequential telephonic interviews on treatment persistence and daily adherence to insulin injections among insulin-na?ve type 2 diabetes patients initiated on different insulin regimens in a 3-month period. Methods: A total of 1,456 insulin-na?ve patients with type 2 diabetes (mean [standard deviation, SD] age: 56.0 [12.0]?years, 49.1% were females) initiated on insulin therapy and consecutively randomized to sequential (n=733) and single (n=723) telephonic interview groups were included. Data on insulin treatment and self-reported blood glucose values were obtained via telephone interview. Logistic regression analysis was performed for factors predicting increased likelihood of persistence and skipping an injection. Results: Overall, 76.8% patients (83.2% in sequential vs 70.3% in single interview group, ( P <0.001) remained on insulin treatment at the third month. Significantly higher rate for skipping doses was noted in basal bolus than in other regimens (27.0% vs 15.0% for premixed and 15.8% basal insulin, respectively, P <0.0001). Logistic regression analysis revealed sequential telephonic interview (odds ratio [OR], 1.531; 95% confidence interval [CI], 1.093–2.143; P =0.013), higher hemoglobin A1c levels (OR, 1.090; 95% CI, 0.999–1.189; P =0.049), and less negative appraisal of insulin therapy as significant predictors of higher persistence. Basal bolus regimen (OR, 1.583; 95% CI, 1.011–2.479; P =0.045) and higher hemoglobin A1c levels (OR, 1.114; 95% CI, 1.028–1.207; P =0.008) were the significant predictors of increased likelihood of skipping an injection. Conclusion: Our findings revealed positive influence of sequential telephonic interview, although including no intervention in treatment, on achieving better treatment persistence in type 2 diabetes patients initiating insulin.