title: Perceptions of general practitioners on initiation and intensification of type 2 diabetes injectable therapies. A quantitative study in the United Kingdom.
abstract: Most diabetes care is done by general practitioners (GPs) in the UK. This study aimed to determine GPs' comfort level in initiating and intensifying injectable therapies, identifying any associated barriers, and assessing reasons for referral to specialists. This web-interview included 128 general practitioners (GPs) experienced in type 2 diabetes (T2D) management, as well as 57 specialists and 30 nurses who were studied for secondary objectives. GPs felt more comfortable initiating the 1st injectable therapy - typically the glucagon-like peptide-1 receptor agonists (GLP-1 RA) - than the 2nd. The main barriers to initiating injectables were related to the complexity of injectable therapies and the lack of comfort with complex patient profiles, namely patients with difficultly achieving glycaemic control or those with significant comorbidities who GPs would rather refer to specialists. The main attributes that would increase their comfort level with initiation of injectables are improved glycaemic control, weight control and low risk of hypoglycaemia. An injectable therapy with these attributes could help to overcome barriers to initiating injectable therapies among GPs other healthcare professionals in primary care.
authors.affiliation: Kantar Health, Calle de Julian Camarillo, 42, 28037 Madrid, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sterzi
authors.affiliation: Kantar Health, 3 Avenue Pierre Massé, 75014 Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Auziere
authors.affiliation: Novo Nordisk, 3 City Place Beehive Ring Road, Gatwick, West Sussex RH6 0PA, UK.
authors.forename: Divina
authors.initials: D
authors.lastname: Glah
authors.affiliation: Novo Nordisk, Arne Jacobsens Allé 17, 9, 2300 København S, Denmark. Electronic address: mmtj@novonordisk.com.
authors.forename: Marie
authors.initials: M
authors.lastname: Markert Jensen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D058005:General Practitioners / Q000523:psychology*; D006442:Glycated Hemoglobin / Q000378:metabolism; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007267:Injections; D008875:Middle Aged; D010465:Perception; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012017:Referral and Consultation; D012307:Risk Factors; D006113:United Kingdom
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: Glucagon-like peptide-1 receptor agonist; Injectable glucose-lowering therapies; Primary care; Type-2 diabetes