Introduction:

Our study aimed at identifying barriers to the initiation of insulin therapy and its associated sociodemographic and labor factors.

Material and Methods:

This cross-sectional study was carried out through a survey applied to 146 general practitioners working in Almada and Seixal primary health care centers, between October and December 2019, assessing their agreement on 30 barriers using a 5-point Likert scale. We used logistic regression to measure the association between each item’s agreement and physician’s factors.

Results:

The response rate was 74%. Physicians’ average age was 44 years, 75% were women and 64% worked in model B family health units. Most physicians agreed with the barriers related to patients’ characteristics and physicians perceived positive impact of insulin on the prognosis of patients. They disagreed with the ones associated with the possibility of harming the doctor-patient relationship and having doubts about who is responsible and when to start insulin. Older doctors disagreed with barriers related to patients’ characteristics and lack of training. As the professional category increases, physicians tend to disagree with factors related to the lack of training, experience, and the doctor-patient relationship. Physicians from non-reformed health units agree that they do not have a multidisciplinary team appropriate for diabetes care.

Discussion:

We identified barriers already described in the literature, especially for younger doctors, in residency and from non-reformed health units.

Conclusion:

These results may be used locally to improve the training of younger doctors and to create multidisciplinary teams dedicated to diabetes in non-reformed health units.

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