Knowledge, attitude, and practice concerning hypoglycaemia, insulin use, and insulin pens in Vietnamese diabetic outpatients: Prevalence and impact on safety and disease control
Thi Kim Cuc Ngo, Thi Ha Vo, Chuyển Lê
Abstract
RATIONALE, AIMS, AND OBJECTIVES: This study aimed to assess the knowledge, attitude, and practice (KAP) of Vietnamese diabetics in an outpatient setting regarding hypoglycaemia, insulin use, and insulin pen and to evaluate the factors related to the KAP, adverse drug reactions (ADRs), and glycaemic control status. METHODS: We interviewed patients by 16-item questions on knowledge and eight questions on attitude, and requested the patient to demonstrate the injection technique with a sampled insulin pen. RESULTS: The response rate was 74% (148 patients included). The proportions of patient having a good knowledge, positive attitude, and good practice were 45.9%, 78.4%, and 44.6%, respectively. The two most common incorrect steps in using insulin pen were skipping to prime pen needle (90.9%) and not removing the used needle from the pen after using (87.8%). Patients using insulin at least 1 year had better knowledge (P = .025), more positive attitude (P = .017), and better practice of using insulin pen (P = .042). Patients had more positive attitude of insulin's role (P = .038) if they either used insulin in combination with oral diabetic medications or had history of using insulin vials. The number of patients having good knowledge was statistically significant higher in participants who previously received counselling from health professionals (P = .001). We also found a positive correlation between good knowledge of patients and good practice skills (P < .001). Patients with poor practice of insulin were more likely to have ADRs at the injection sites (P = .013). The patients with poorer level of knowledge had significant higher risk of hypoglycaemia (P = .001). KAP levels did not correlate with glycaemic control status. CONCLUSIONS: The majority of outpatients had positive attitude towards insulin's role; however, their knowledge and practice of hypoglycaemia and using insulin pen needs improvement. This study will be helpful in the planning of patient education strategies.