- This topic has 61 replies, 49 voices, and was last updated 2 weeks, 5 days ago by Trisha Hood.
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January 9, 2023 at 2:46 pm #29443Faucy BKeymasterThe Essentials Clinical Resource Tool (Annual)
What barriers do you face in individualizing antihyperglycemic agents? Please share any strategies that have worked for you.
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April 3, 2023 at 8:40 pm #31190Annabelle BittleParticipantThe Essentials Clinical Resource Tool (Annual)
Barriers I have encountered with patients are motivation & cost of the medications
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April 4, 2023 at 11:56 am #31197Linda DubeParticipantDiabetes Education
barriers are pt motivation and insurance coverage
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April 4, 2023 at 11:57 am #31198Linda DubeParticipantDiabetes Education
1
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April 4, 2023 at 7:32 pm #31205Shauna ProutenParticipantDiabetes Education
Usually the biggest barriers are medical complexity /frailty and cost of treatment
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April 6, 2023 at 12:59 pm #31223Veronica TooleyParticipantDiabetes Education
cost of medication and lack of coverage in many drug plans and patient motivation to sustain change long term
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April 6, 2023 at 1:00 pm #31224Veronica TooleyParticipantDiabetes Education
above
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April 9, 2023 at 3:40 pm #31231Shereen ElsayadParticipantDiabetes Education
cost, coverage and clinician reluctancy to change when A1C is at target
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April 11, 2023 at 9:56 pm #31237Brittany ParmentierParticipantDiabetes Education
Cost and coverage
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April 14, 2023 at 4:50 pm #31239Kyla AbenParticipantDiabetes Education
Some barriers are client hesitancy due to insufficient client knowledge and (expressed) lack of previous client involvement/engagement or client centered care with health care providers. My strategies to over come this is to work on building a therapeutic relationship that is client centered. I support building confidence and empowerment in clients management of their diabetes care. I explore their experiences and offer support and information to be able to make informed decisions with regards to their care.
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April 17, 2023 at 9:10 pm #31243Linda KellandParticipantDiabetes Education
Most common barriers encountered relating to individualizing antihyperglycemic agents are costs of the medications for the patients and fear of needles when GLP1 agonists or insulins are recommended.
Demonstrating the ease with which these medications are delivered with demo devices helps patients accept them and feel confident using the devices. -
April 20, 2023 at 3:04 pm #31253Linda MirekuParticipantDiabetes Education
Income of clients impacts the diet modifications that work well with antihyperglycemic agents. Non adherent of diet modification poses a big challenge to individualizing glycemic agents. It took a long time for a client whose main staple was ramen, to incorporate dry legumes and other cheaper options of foods with low glycemic index ratio in her diet . She could not afford healthier food options like vegetables most of the times and legumes were foreign to her.
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May 5, 2023 at 1:41 pm #31294Marlena MorrisonParticipantDiabetes Education
The main barriers I have faced in my practice for individualizing antihyperglycemic agents include drug coverage/cost, increased frailty, and complex comorbidities ie liver cirrhosis, ESRD, and cogntive impairment. In Ontario, where I am located, for those who do have private coverage or coverage under the Ontario Drug Benefit, I find the biggest barrier to individualizing antihyperglycemic agents is recultance to add an additional medication (ie polypharmacy) and concerns regarding potential associated side effects with some antihyperglycemic agents. I find exploring these concerns and using reflective listening to be a good approach, as well as providing the necessary education an individual needs to make an informed decision without casting judgement.
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May 11, 2023 at 3:49 pm #31315Laurie CornelisParticipantThe Essentials CDE Exam Prep Package
Cost is a barrier to optimal care
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May 11, 2023 at 3:49 pm #31316Laurie CornelisParticipantThe Essentials CDE Exam Prep Package
Cost is a barrier to care
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May 16, 2023 at 6:47 pm #31329Ana NevesParticipantDiabetes Education
I always find if cost is a barrier to any type of treatment, then there will always be difficulty in maintaining client engagement. Diet and exercise is cumbersome to many yet the effective lifestyle changes could ultimately bring down the cost of the pharmacotherapy.
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May 22, 2023 at 5:40 pm #31341Alexandra GloverParticipantDiabetes Education
Barriers I have encountered for patents are cost of medications, compliance, and diet/exercise concerns.
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May 25, 2023 at 3:36 pm #31346Bukola LumorParticipantDiabetes Education
cost ,coverage,adverse reactions are barriers
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May 29, 2023 at 12:15 am #31352Jamie SchmidtkeParticipantDiabetes Education
Cost without adequate coverage, is a large barrier for treatment along with motivation towards self-care. Some barriers in seniors care, can be related to the decisions made by legal representatives towards treatment options. Whether this is related to misinformation, costs of treatments, or values/beliefs, the patient-care direction is influenced with each.
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June 9, 2023 at 3:46 pm #31371Janet WilpstraParticipantDiabetes Education
Pill burden is a big barrier for my clients as well as compliance in taking medications.
When we begin discussing the need for an add on OHA there is often hesitancy to “take one more pill”.
I try to offer combination options as often as possible to ease that burden as well as giving once daily options.
Regarding compliance, I educate regarding the purpose of each of the medications so that there is an understanding of their action profile in the body and why the medication has been prescribed. -
June 13, 2023 at 10:25 pm #31378Kathryn BourqueParticipantDiabetes Education
Compliance and understanding. Health literacy is an issue for many. It is necessary to use plain language and sometimes even pictures to show how and where in the body the medication is working.
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June 16, 2023 at 7:15 pm #31382Ana NevesParticipantDiabetes Education
cost of treatment, accessibility and support
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June 23, 2023 at 8:44 pm #31401Idia UmoluParticipantThe Essentials Clinical Resource Tool (Annual)
The major barrier for most of my clients is cost. Many of them don’t have drug coverage.
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June 25, 2023 at 4:34 pm #31402Muhammad Nasir RafiqueParticipantDiabetes Education
Cost and patient’s motivation
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July 17, 2023 at 5:08 pm #31417Hilda MarianoParticipantDiabetes Education
In the areas that I cover, access to prescribers is a huge issue. Many clients find it difficult to attend appointments with their prescriber/ Family doctor due to issues like transportation, staff turnover and racism.
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July 17, 2023 at 7:10 pm #31419Julie DouvilleParticipantDiabetes Education
What works nicely is offering different options with their pros and cons, including insulin. Chosen option is tried and changed if needed. The decision is theirs.
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July 18, 2023 at 12:01 am #31421Roshni JohnParticipantDiabetes Education
Cost and lack of adherence to recommended dietary changes
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July 31, 2023 at 6:21 pm #31439Su GuptaParticipantDiabetes Education
I echo all of the concerns voiced above and by far it seems that a lack of motivation, the inability to maintain the healthy eating behavior long term is a challenge. This applies to self management of most chronic conditions. As an RD CDE and health coach, I try to use more action based strategies, involve pt. more in their own decisions, empower them with easy to sue tools and encourage routine follow ups with their diabetes care team. People tend to slack off on their follow ups once the A1c is on target.
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August 15, 2023 at 2:49 pm #31453faiza hemrajParticipantDiabetes Education
yes
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August 15, 2023 at 4:13 pm #31454Bailey McNuttParticipantThe Essentials Clinical Resource Tool (Annual)
Cost is a big issue but even when medications are covered or cost is not an issue, a lot of patients do not want to start a new medication or are only willing to start if it is place of something else.
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August 22, 2023 at 2:13 pm #31461Dhiraj VermaParticipantDiabetes Education
cost is the most common barrier
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September 4, 2023 at 6:29 am #31466Michael AmattoParticipantDiabetes Education
cost/coverage issues
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September 7, 2023 at 6:32 pm #31520Maike LorenzenParticipantDiabetes Education
Costs to patients without extended healthcare plan or coverage by the government determine most of my treatment choices.
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September 13, 2023 at 6:31 pm #31522Ravneet DhillonParticipantDiabetes Education
Cost and Coverage are big barriers for most patients. This dictates treatment choices. Maintaining healthy eating choices is anouther big one.
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September 21, 2023 at 6:24 pm #31526Andreane BaretteParticipantDiabetes Education
Cost and coverage issues
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September 28, 2023 at 1:11 pm #31529Natalie GreenParticipantDiabetes Education
There are many barriers to compliance with medication. Some of which include lack of understanding and motivation, lack of funds to purchase medication, not believing that they have diabetes and concerns about medication side efects.
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September 28, 2023 at 1:12 pm #31530Natalie GreenParticipantDiabetes Education
Medication side effects, lack of knowledge and understanding, cost
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October 18, 2023 at 5:59 pm #31817Andrea PortelanceParticipantDiabetes Education
Motivation (wrap in medication compliance) probably continues to be the biggest barriers. With an ongoing aging population and increasing diagnosis for co-morbidities, motivational interviewing skills become so important to be able to evaluate where a patient is in their understanding and compliance to any changes in their regular routine (Lifestyle/nutrition/activity/financial, etc).
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October 20, 2023 at 11:22 am #31822Joanne TremblettParticipantDiabetes Education
Cost and coverage
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October 24, 2023 at 6:41 pm #31865Mary GuetgParticipantDiabetes Education
Low health literacy, transportation to appointments, lack of resources to start healthy interventions.
Strategies that are working: allowing for longer appointments, incentivized walking program, offering ongoing support with Ozempic injections, rtCGM systems. -
October 25, 2023 at 1:50 pm #31891Andrea PortelanceParticipantDiabetes Education
Polypharmacy, Cost and motivation tend to be the most impacting medication adherence.
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October 25, 2023 at 3:47 pm #31893Kim ScrivenParticipantDiabetes Education
Cost, coverage and prescriber comfort prescribing.
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October 27, 2023 at 2:26 pm #32192Saravanan BheemanParticipantDiabetes Education
cost, adherence to medications, insurance coverage, inertia from physician’s side are some of the barriers.
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November 4, 2023 at 3:01 am #32232Puneet KalkatParticipantDiabetes Education
mostly cost
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November 16, 2023 at 6:06 pm #32281StellaParticipantThe Essentials Clinical Resource Tool (Annual)
Cost/coverage issues
most people do not have physicians to prescribe the medications needed.
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November 23, 2023 at 8:03 pm #32287Barbara HallParticipantDiabetes Education
As others have stated, cost of medications is a large barrier to changes/ additions to AHA therapy.
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December 4, 2023 at 4:17 pm #32295Jasmin GregoryParticipantDiabetes Education
Agreed, the cost of medication is unfortunate for those who do not qualify for government or other funding
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December 6, 2023 at 8:17 pm #32312Barbara HallParticipantDiabetes Education
A more recent complication that has been occurring is the transfer of what is covered… Namely biosynthetic insulin has been the only insulin covered by many insurance plans now (as well as the Ontario drug benefit). I have had a lot of push back from clients, so much so that they are choosing to pay out of pocket to continue to use their current insulins. I feel as though insurance and government plans should be considering “grandfathering” in the current insulin being used by individuals. It seems like a lot of undue stress and potential issues.
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December 26, 2023 at 7:45 am #32324Abderrahmane Boumediene DerkaouiParticipantDiabetes Education
Motivation and cost are the most important barriers
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December 26, 2023 at 7:45 am #32325Abderrahmane Boumediene DerkaouiParticipantDiabetes Education
he emergence of new weight loss drugs has sparked considerable interest in the field of diabetes management, particularly in relation to diabetes remission. These innovative medications exhibit significant potential not only in aiding individuals in achieving sustainable weight loss but also in contributing to the remission of diabetes. The correlation between excess weight and the development of diabetes is well-established, and these novel drugs, with their targeted mechanisms of action, offer a promising avenue for addressing both issues simultaneously. As research progresses, there is growing optimism that these drugs may play a pivotal role in not only mitigating the symptoms of diabetes but potentially inducing remission in certain cases. The integration of these weight loss drugs into comprehensive diabetes care plans holds the promise of providing more effective and holistic treatment options for individuals struggling with both conditions, offering a new frontier in the pursuit of improved health outcomes.
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January 2, 2024 at 7:11 pm #32332Manju PatilParticipantDiabetes Education
Cost is definitely in low income group or having no drug coverage. But some time physician / pharmacy also has no time to explain option for them.
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January 2, 2024 at 7:13 pm #32333Manju PatilParticipantDiabetes Education
For me health education is important because different cultures have different beliefs asking open ended questions and making general about their diet helps along with medication therapy, importance of daily movement with reward helps for my clients.
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January 2, 2024 at 7:16 pm #32334Manju PatilParticipantDiabetes Education
antihyperglycemic drugs based on ALC target in place and pt goal , understanding of following drug therapy with other factors
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January 3, 2024 at 10:05 pm #32337Idia UmoluParticipantThe Essentials Clinical Resource Tool (Annual)
Barriers faced by some clients is the affordability of medications. Some are forced to decide between buying medication or food or paying rent.
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March 7, 2024 at 5:10 pm #32412Angela Walker-SterlingParticipantDiabetes Education
Ditto for cost.
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April 4, 2024 at 6:45 pm #32424Shireen AteerehParticipantDiabetes Education
Coverage eligibility for senior plans
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July 9, 2024 at 11:25 pm #32496Mary Josette SungcangParticipantDiabetes Education
Pharmacotherapy tailored for safety dosing and monitored for effectivity and readjusted as needed.
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July 10, 2024 at 12:00 am #32497Mary Josette SungcangParticipantDiabetes Education
One of the challenges in pharmacotherapy is the comorbiidities and ever changing conditions of the fragile elderly populations.
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July 10, 2024 at 12:11 am #32499Mary Josette SungcangParticipantDiabetes Education
Informative and Critically helpful!
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August 15, 2024 at 2:03 pm #32539Kristy BrayParticipantThe Essentials Clinical Resource Tool (Annual)
affordability is a MAJOR factor.
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October 18, 2024 at 3:13 pm #32632Bakil SaifParticipantDiabetes Education
The availability of antidiabetic drugs in district areas plays role and challenges for primary care physicians
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October 24, 2024 at 9:12 pm #32638Trisha HoodParticipantThe Essentials CDE Exam Prep Package
people become frustrated when they experience side effects, nausea, diarrhea, increased urination etc
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