Keywords
Primary health care
Insulin therapy
Insulin
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Abstract
Objective: To identify the knowledge produced regarding the role of primary health care (PHC) in the care of patients on insulin therapy from 2013 to 2023. Methods: This bibliographic review incorporated qualitative and quantitative approaches. The search strategy involved four databases: PubMed/Medline, SCOPUS, LILACS, and Scielo, using specific keywords. Inclusion and exclusion criteria were applied to select articles published between 2013 and 2023 in Portuguese, English, or Spanish. Articles were evaluated based on titles, abstract analysis, and full reading. Results: A total of 359 references were found, of which 26 were selected. The results highlight that the prescription and adherence to insulin therapy in PHC are influenced by the doctor-patient relationship and patient insecurities. Effective interventions in PHC can improve the prescription and adherence to insulin. Final considerations: Addressing diabetes in primary care is crucial for reducing complications and mortality. Insulin therapy faces challenges such as patient resistance and a lack of specialists. A multidisciplinary approach involving doctors, nurses, and other health professionals is essential to enhance health education and treatment adherence.
References
ALHAGAWY AJ, et al. Barriers and Attitudes of Primary Healthcare Physicians to Insulin Initiation and Intensification in Saudi Arabia. International Journal of Environmental Research and Public Health, 2022; 19(24): 16794.
ALMEIDA TP DE e PENA PGL. Experiences and narratives of patients with type 2 diabetes mellitus in the city of Salvador (Bahia) related to the difficulties in changing lifestyle behaviors. Physis: Revista de Saúde Coletiva, 2021; 31(4).
AMARAL VRS, et al. Factors associated with knowledge of the disease in people with type 2 diabetes mellitus. Investigación y Educación en Enfermería, 2021; 39(1).
BERTOLDO CDS, et al. Caracterização de adolescentes com diabetes mellitus atendidos em ambulatório de hospital de ensino. Revista de Enfermagem da UFSM, 2019; 9: 55.
CARVALHO FS, et al. COMBINSI (COMBat to INSufficient Insulin therapy) – A Portuguese project in type 2 diabetes. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2023; 17(5): 102776.
CARVALHO GCN, et al. Acuidade visual no manejo do diabetes mellitus: preparo da dose de insulina. Acta Paulista de Enfermagem, 2017; 30(1): 25–30.
CUNHA GH, et al. Prática insulinoterápica realizada por pessoas com diabetes na Atenção Primária em Saúde. Revista da Escola de Enfermagem da USP, 2020; 54.
GRILLO MFF, et al. Diabetes education in primary care: a randomized clinical trial. Cadernos de Saúde Pública, 2016; 32(5).
HERTROIJS DFL, et al. Relevant patient characteristics for guiding tailored integrated diabetes primary care: a systematic review. Primary Health Care Research & Development, 2018; 19(5): 424–447.
KOSTEV K, et al. Time to Insulin Initiation in Type 2 Diabetes Patients in 2010/2011 and 2016/2017 in Germany. Journal of Diabetes Science and Technology, 2019; 13(6): 1129–1134.
LOPES P e JUNGES JR. Gerenciamento do diabetes por profissionais e usuários da Atenção Primária à Saúde. Physis: Revista de Saúde Coletiva, 2021; 31(3).
MATA‐CASES M, et al. Clinical characteristics of type 2 diabetic patients on basal insulin therapy with adequate fasting glucose control who do not achieve HbA1c targets. Journal of Diabetes, 2017; 9(1): 34–44.
MUZY J, et al. Caracterização da atenção ao paciente com diabetes na atenção primária a partir do PMAQ-AB. Ciência & Saúde Coletiva, 2022; 27(9): 3583–3602.
NASRUDDIN A, et al. Insulin Adherence and Associated Factors in Patients with Type 2 Diabetes Mellitus Treated in Klang Primary Health Care Centres. Malaysian Journal of Medical Sciences, 2021; 28(6): 76–87.
NGASSA PIOTIE P, et al. Factors affecting the implementation of a complex health intervention to improve insulin management in primary care: A SWOT analysis. African Journal of Primary Health Care & Family Medicine, 2022; 14(1).
OLIVEIRA REM, et al. Uso e acesso aos medicamentos para o diabetes mellitus tipo 2 em idosos: um estudo de base populacional. Ciência & Saúde Coletiva, 2021; 26(3): 5081–5088.
PEREIRA LB, et al. Avaliação da efetividade do acompanhamento farmacoterapêutico no controle do diabetes mellitus tipo 2 em longo prazo. Clinical & Biomedical Research, 2018; 38(3): 237–244.
RIBEIRO ASR, et al. Construção e validação de tecnologia educacional sobre insulinoterapia: estudo metodológico. Cogitare Enfermagem, 2023; 28.
ROSSANEIS MA, et al. Fatores associados ao controle glicêmico de pessoas com diabetes mellitus. Ciência & Saúde Coletiva, 2019; 24(3): 997–1005.
ROTH J, et al. People with Type 2 Diabetes on Premixed Insulin Therapy: How is the Daily Insulin Dose Partitioned and are there Effects on the Metabolic Control? Experimental and Clinical Endocrinology & Diabetes, 2015; 123(6): 368–370.
SANTOS AL, et al. Adherence to the treatment of Diabetes mellitus and relationship with assistance in primary care. Reme Revista Mineira de Enfermagem, 2020; 24.
CAVAIOLA, et al. Primary Care Management of Patients With Type 2 Diabetes: Overcoming Inertia and Advancing Therapy With the Use of Injectables. Clinical Therapeutics, 2019; 41(2): 352–367.
SELVADURAI S, et al. Impact of pharmacist insulin injection re-education on glycemic control among type II diabetic patients in primary health clinics. Saudi Pharmaceutical Journal, 2021; 29(7): 670–676.
SIDORENKOV G, et al. HbA1c response after insulin initiation in patients with type 2 diabetes mellitus in real life practice: Identifying distinct subgroups. Diabetes, Obesity and Metabolism, 2018; 20(8): 1957–1964.
NASCIMENTO MT, et al. Fatores de risco associados ao desenvolvimento do pé diabético e ações executadas na Atenção Primária à Saúde para prevenção do agravo. Revista Eletrônica Acervo Saúde, 2019; (33): 1371.
TONETTO IFA, et al. Quality of life of people with diabetes mellitus. Revista da Escola de Enfermagem da USP, 2019; 53.
XU Y, et al. Investigation on the association between diabetes distress and productivity among patients with uncontrolled type 2 diabetes mellitus in the primary healthcare institutions. Primary Care Diabetes, 2020; 14(5): 538–544.