ArticleSouth African family practice : official journal of the South African Academy of Family Practice/Primary Care2023
Factors influencing insulin initiation in primary care facilities in Cape Town, South Africa.
Article in South African family practice : official journal of the South African Academy of Family Practice/Primary Care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mapping research trends in shared decision-making for type 2 diabetes mellitus: a bibliometric study.Frontiers in health services · 2026Pooled it
- Article
- Sociodemographic and biological determinants of insulin initiation in type 2 diabetes: a cohort study using routinely collected primary care data.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Material needs security and cardiovascular risk factors in rural South Africa.BMC public health · 2024Observational
- Evaluating the implementation of group empowerment and training (GREAT) for diabetes in South Africa: convergent mixed methods.BMJ open · 2024Article
- The sustainability of group empowerment and training for people with diabetes in South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
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Authors and funding
2 authors.
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Abstract
backgroundType 2 diabetes (T2DM) is a leading cause of mortality in South Africa and resistance to the use of insulin is common. This study aimed to explore factors that influence the initiation of insulin in patients with T2DM in primary care facilities in Cape Town, South Africa.
methodsAn exploratory descriptive qualitative study was conducted. Seventeen semi-structured interviews were held with patients eligible for insulin, on insulin and primary care providers. Participants were selected by maximum variation purposive sampling. Data were analysed using the framework method in Atlas-ti.
resultsFactors related to the health system, service delivery, clinical care and patients. Systemic issues related to the required inputs of workforce, educational materials, and supplies. Service delivery issues related to workload, poor continuity and parallel coordination of care. Clinical issues related to adequate counselling. Patient factors included a lack of trust, concerns about injections, impact on lifestyle and disposal of needles.
conclusionAlthough resource constraints are likely to remain, district and facility managers can improve supplies, educational materials, continuity and coordination. Counselling must be improved and may require innovative alternative approaches to support clinicians who face high number of patients. Alternative approaches using group education, telehealth and digital solutions should be considered.Contribution: This study identified key factors influencing insulin initiation in patients with T2DM in primary care. These can be addressed by those responsible for clinical governance, service delivery and in further research.
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