Barreiras determinantes para a não adesão a insulinoterapia por pacientes com diabetes mellitus tipos 2: uma revisão integrativa

Abstract

Type 2 diabetes mellitus (DM2) is the main cause of early mortality in most countries, representing enormous human, social and economic consequences. Insulin adherence can prevent diabetes complications, whoever healthcare professionals face challenges for patient adherence. It was conduct an integrative review of literature on the barriers that people with DM2 face for non adherence of treatment using insulins. The PICO strategy was applied to the subsequent research question construction: “What are the determinants barriers for non adherence of insulin therapy for type 2 diabetetic patients?”. The database used for the study are: PubMed, Medline, Scopus and Web of Science. The descriptors extracted from DeCS and keywords from similar articles: “Type 2 diabetes mellitus”, “barriers”, “insulin initiation”, “insulin nonadherence” and “insulin refusal”, combined with boolean operators OR/AND. It was included scientific articles with open acess, in portuguese, english and spanish, published between 2011 and 2021, that answer the guiding question. It was excluded dissertations, teses, literature reviews and article that explore the view of healthcare professionals only. From the analyses of 21 articles, it was found 21 main barriers for non adherence: Treatment inconvenience, physical impacts, fear of pain/inejction, insulin dependence, lack of knowledge and others. Non insulin adherence face multifactorials barriers, part of these barriers come from misuderstandings and myths constructed troughout patients life. Healthcare professionals must identify the barriers of non adherence readily, thus easier will be to create strategies to overcome it and contribute to better patient quality of life.