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    Insulin initiation status of primary care physicians in Turkey, barriers to insulin initiation and knowledge levels about insulin therapy: A multicenter cross-sectional study
    (Elsevier Sci Ltd, 2017) Ates, Elif; Set, Turan; Saglam, Zuhal; Tekin, Nil; Eray, Irep Karatas; Yavuz, Erdinc; Sahin, Mustafa Kursat
    Aims: Our aim was to evaluate the insulin initiation status, barriers to insulin initiation and knowledge levels about treatment administered by primary care physicians (PCP). Methods: We conducted our study in accordance with a multicenter, cross-sectional design in Turkey, between July 2015 and July 2016. A questionnaire inquiring demographic features, status of insulin initiation, obstacles to insulin initiation and knowledge about therapy of the PCPs was administered during face-to-face interviews. Results: 84 PCPs (19%) (n =446, mean age =41.5 +/- 8.4years, 62.9% male and 90.0% ministry certified family physicians) initiated insulin therapy in the past. Most of the stated primary barriers (51.9%, n=230) were due to the physicians. The most relevant barrier was lack of clinical experience with a rate of 19% (n = 84 of the total). The average total knowledge score was 5.7 +/- 2.0 for the family medicine specialist, and 3.81 +/- 2.1 for the ministry certified family physicians (p= 0.000, maximum knowledge score could be 10). Conclusions: The status of insulin initiation in Turkey by the primary care physicians is inadequate. Medical education programs and health care systems may require restructuring to facilitate insulin initiation in primary care. (C) 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.