Insulin Injection Technique Education: A survey on knowledge and practice of insulin injection technique education among physicians in Indonesia (Preprint)

Abstract

Insulin therapy is crucial for diabetes management, and its effectiveness is well-established. With better access to health services, adherence to guidelines, and the availability of insulin, its usage in Indonesia may rise. However, prescribing insulin poses challenges such as storage issues, patient preparation, and proper injection techniques, all of which can impact insulin's effectiveness. Patient education is vital for successful diabetes management, especially for those on insulin. Indonesia has guidelines for insulin injection techniques, adapted from the Forum for Injection Technique and Therapy Experts (FITTER), but proper insulin use remains insufficient. A preliminary study at a Jakarta hospital revealed that only 6.1% of diabetes patients received education during outpatient treatment.

This study seeks to investigate physicians' knowledge and practice in providing education on insulin use to diabetes patients in Indonesia, as no previous research has addressed this issue.

This study recruited potential participants (all physicians in Indonesia) through the internet using convenience sampling method. Participants gave their informed consent before completing the questionnaire. The online questionnaire was created by the research team and pretested on 30 individuals before distributed to participants. The survey lasted from February to March 2021.

A total of 823 participants were included in the analysis. More than 80% of the participants had given insulin education to patients at least once during the last 30 days. However, only 58.20% used specific guidelines in their practice, with only 34.02% aware of the Indonesian guideline. Almost all (99.03%) participants agreed that insulin injection techniques would affect clinical results. The median score of knowledge about insulin injection techniques were 7 (IQR 2) among the study participants.

Most physicians in this study had given education to their patients. However, there was still a gap between the guideline and practice of insulin education, as shown by the lack of awareness and the fair level of knowledge about the Indonesian guideline.