Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study

Woon May Ong,1 Siew Siang Chua,1 Chirk Jenn Ng2 1Department of Pharmacy, 2University of Malaya Primary Care Research Group (UMPCRG), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Background: Self-monitoring of blood glucose (SMBG) helps to im...

Full description

Bibliographic Details
Main Authors: Ong WM, Chua SS, Ng CJ
Format: Article
Language:English
Published: Dove Medical Press 2014-02-01
Series:Patient Preference and Adherence
Online Access:http://www.dovepress.com/barriers-and-facilitators-to-self-monitoring-of-blood-glucose-in-peopl-a15828
_version_ 1811300029162323968
author Ong WM
Chua SS
Ng CJ
author_facet Ong WM
Chua SS
Ng CJ
author_sort Ong WM
collection DOAJ
description Woon May Ong,1 Siew Siang Chua,1 Chirk Jenn Ng2 1Department of Pharmacy, 2University of Malaya Primary Care Research Group (UMPCRG), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Background: Self-monitoring of blood glucose (SMBG) helps to improve glycemic control and empowerment of people with diabetes. It is particularly useful for people with diabetes who are using insulin as it facilitates insulin titration and detection of hypoglycemia. Despite this, the uptake of SMBG remains low in many countries, including Malaysia. Purpose: This study aimed to explore the barriers and facilitators to SMBG, in people with type 2 diabetes using insulin. Patients and methods: Qualitative methodology was employed to explore participants’ experience with SMBG. Semistructured, individual in-depth interviews were conducted on people with type 2 diabetes using insulin who had practiced SMBG, in the primary care clinic of a teaching hospital in Malaysia. Participants were purposively sampled from different age groups, ethnicity, education level, and level of glycemic control (as reflected by the glycated hemoglobin [HbA1c]), to achieve maximum variation in sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked, and analyzed using a thematic approach. Results: A total of 15 participants were interviewed, and thematic saturation was reached. The factors that influenced SMBG were mainly related to cost, participants' emotion, and the SMBG process. The barriers identified included: frustration related to high blood glucose reading; perception that SMBG was only for insulin titration; stigma; fear of needles and pain; cost of test strips and needles; inconvenience; unconducive workplace; and lack of motivation, knowledge, and self-efficacy. The facilitators were: experiencing hypoglycemic symptoms; desire to see the effects of dietary changes; desire to please the physician; and family motivation. Conclusion: Participants’ perceptions of the purpose of SMBG, the emotions associated with SMBG, and the complexity, pain, and cost related to SMBG as well as personal and family motivation are the key factors that health care providers must consider when advising people with diabetes on SMBG. Keywords: blood glucose self-monitoring, diabetes mellitus, in-depth interviews, qualitative study
first_indexed 2024-04-13T06:45:11Z
format Article
id doaj.art-e5215c51a88442069f3e9a5f02c7e0a3
institution Directory Open Access Journal
issn 1177-889X
language English
last_indexed 2024-04-13T06:45:11Z
publishDate 2014-02-01
publisher Dove Medical Press
record_format Article
series Patient Preference and Adherence
spelling doaj.art-e5215c51a88442069f3e9a5f02c7e0a32022-12-22T02:57:38ZengDove Medical PressPatient Preference and Adherence1177-889X2014-02-012014default23724615828Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative studyOng WMChua SSNg CJWoon May Ong,1 Siew Siang Chua,1 Chirk Jenn Ng2 1Department of Pharmacy, 2University of Malaya Primary Care Research Group (UMPCRG), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Background: Self-monitoring of blood glucose (SMBG) helps to improve glycemic control and empowerment of people with diabetes. It is particularly useful for people with diabetes who are using insulin as it facilitates insulin titration and detection of hypoglycemia. Despite this, the uptake of SMBG remains low in many countries, including Malaysia. Purpose: This study aimed to explore the barriers and facilitators to SMBG, in people with type 2 diabetes using insulin. Patients and methods: Qualitative methodology was employed to explore participants’ experience with SMBG. Semistructured, individual in-depth interviews were conducted on people with type 2 diabetes using insulin who had practiced SMBG, in the primary care clinic of a teaching hospital in Malaysia. Participants were purposively sampled from different age groups, ethnicity, education level, and level of glycemic control (as reflected by the glycated hemoglobin [HbA1c]), to achieve maximum variation in sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked, and analyzed using a thematic approach. Results: A total of 15 participants were interviewed, and thematic saturation was reached. The factors that influenced SMBG were mainly related to cost, participants' emotion, and the SMBG process. The barriers identified included: frustration related to high blood glucose reading; perception that SMBG was only for insulin titration; stigma; fear of needles and pain; cost of test strips and needles; inconvenience; unconducive workplace; and lack of motivation, knowledge, and self-efficacy. The facilitators were: experiencing hypoglycemic symptoms; desire to see the effects of dietary changes; desire to please the physician; and family motivation. Conclusion: Participants’ perceptions of the purpose of SMBG, the emotions associated with SMBG, and the complexity, pain, and cost related to SMBG as well as personal and family motivation are the key factors that health care providers must consider when advising people with diabetes on SMBG. Keywords: blood glucose self-monitoring, diabetes mellitus, in-depth interviews, qualitative studyhttp://www.dovepress.com/barriers-and-facilitators-to-self-monitoring-of-blood-glucose-in-peopl-a15828
spellingShingle Ong WM
Chua SS
Ng CJ
Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study
Patient Preference and Adherence
title Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study
title_full Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study
title_fullStr Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study
title_full_unstemmed Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study
title_short Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study
title_sort barriers and facilitators to self monitoring of blood glucose in people with type 2 diabetes using insulin a qualitative study
url http://www.dovepress.com/barriers-and-facilitators-to-self-monitoring-of-blood-glucose-in-peopl-a15828
work_keys_str_mv AT ongwm barriersandfacilitatorstoselfmonitoringofbloodglucoseinpeoplewithtype2diabetesusinginsulinaqualitativestudy
AT chuass barriersandfacilitatorstoselfmonitoringofbloodglucoseinpeoplewithtype2diabetesusinginsulinaqualitativestudy
AT ngcj barriersandfacilitatorstoselfmonitoringofbloodglucoseinpeoplewithtype2diabetesusinginsulinaqualitativestudy