Comparative assessment of Knowledge, Attitude and Practice of Insulin Use Amongst Diabetic Patients in two Hospitals in Kenya

Abstract

The aim of this study was to do a comparative assessment of knowledge, attitude and practice of insulin use amongst diabetic patients in two selected hospitals in Kenya. The knowledge, attitude and practice (KAP) around insulin use by patients is inadequately studied and poorly understood. A comparative, cross-sectional study design was adopted. Three hundred participants were interviewed between May and July 2023 at the pharmacies dedicated to the diabetes clinics in Kenyatta National Hospital (KNH) and Presbyterian Church of East Africa Kikuyu Hospital (PKH). Descriptive and inferential data analysis were done using STATA with the level of significance set at 0.05. Participants in both facilities demonstrated good knowledge and practice with notable interfacility differences in body mass index (p<0.001), occupation (p<0.001), family history of diabetes (p<0.001), and a history of diabetes complications (p<0.001). Higher knowledge (20 [17, 23]) and practice scores (3 [3,3]) were achieved in PKH compared to KNH, and this difference was statistically significant (p<0.001). The facility where one received care was the best predictor for both knowledge and practice on insulin, with PKH exhibiting better odds of good knowledge (aOR: 7.087, 95% C.I: 3.941,12.744) and practice (aOR:  10.926, 95% C.I: 4.232,28.21) compared to KNH. The attitude was favourable in both facilities. Insulin storage practices were poor in both facilities, and the frequency of replacing insulin needles was wanting.   Better knowledge and practice of insulin use were demonstrated by PKH. Training is needed to improve selected practices. Possible explanations for interfacility differences should be explored.