What is so tough about self‐monitoring of blood glucose? Perceived obstacles among patients with Type 2 diabetes. Issue 1 (19th July 2013)

• Record Type: Journal Article
• Authors: Polonsky, W. H.; Fisher, L.; Hessler, D.; Edelman, S. V.
• Is Part Of: Diabetic medicine. Volume 31:Issue 1(2014:Jan.)
• Page Start: 40
• Page End: 46
• Publication Date: 2013-07-19
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12275
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12275-abs-0001"> <title>Abstract</title> <sec id="dme12275-sec-0001" sec-type="section"> <title>Aims</title> <p>To identify patient‐reported obstacles to self‐monitoring of blood glucose among those with Type 2, both insulin users and non‐insulin users, and to investigate how obstacles are associated with frequency of self‐monitoring and use of self‐monitoring data.</p> </sec> <sec id="dme12275-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients with Type 2 diabetes (<italic>n </italic>= 886, 65% insulin users) who attended a 1‐day diabetes education conference in cities across the USA completed a survey on current and recommended self‐monitoring of blood glucose frequency, how they used self‐monitoring results and perceived obstacles to self‐monitoring use. Exploratory factor analysis examined 12 obstacle items to identify underlying factors. Regression analyses examined associations between self‐monitoring of blood glucose use and the key obstacle factors identified in the exploratory factor analysis.</p> </sec> <sec id="dme12275-sec-0003" sec-type="section"> <title>Results</title> <p>Three obstacle factors emerged: Avoidance, Pointlessness and Burden. Avoidance was the only significant independent predictor of self‐monitoring frequency (β = −0.23, <italic>P</italic> < 0.001). Avoidance (β = −0.12, <italic>P</italic> < 0.01) and Pointlessness (β = −0.15, <italic>P</italic> < 0.001) independently predicted how often self‐monitoring data were shared with healthcare professionals and whether or not data were used to make management adjustments (Avoidance: odds ratio = 0.74, <italic>P</italic> < 0.001; Pointlessness: odds ratio = 0.75, <italic>P</italic> < 0.01). Burden was not associated with any of the self‐monitoring behavioural measures. Few differences between insulin users and non‐insulin users were noted.</p> </sec> <sec id="dme12275-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Obstacles to self‐monitoring of blood glucose use, both practical and emotional, were common. Higher levels of Avoidance and Pointlessness, but not Burden, were associated with less frequent self‐monitoring use. Addressing patients' self‐monitoring‐related emotional concerns (Avoidance and Pointlessness) may be more beneficial in enhancing interest and engagement with self‐monitoring of blood glucose than focusing on day‐to‐day, behavioural issues (Burden).</p> </sec> </abstract>