Insulin Administration and the Impacts of Forgetting a Dose

Meryl Brod1§, Betsy Pohlman1, Jens Harald Kongsø2

1The Brod Group, 219 Julia Avenue, Mill Valley, California, USA

Telephone: 415 381-5532; FAX: 415 381-0653; E-mail:

2 Novo Nordisk A/S, Vandtårnsvej 114, DK-2860 Søborg, DENMARK

§Corresponding author

Online Resource 1

Semi Structured Discussion Guide

Introductions:

Purpose, procedures, and housekeeping:

Hello, my name is_____ and I am going to be your group leader for this evening. Thank you for agreeing to participate in this focus group to discuss your experience with your insulin medication. You are all here because you all have said that sometime in the last month or so you have either worried about or had trouble remembering to take your insulin at the right time, could not remember when you took your last dose or how much insulin you took at your last dose. So no one needs to be embarrassed, as all of you have had similar experiences with worrying or forgetting. Your comments will be used to help develop a survey of the impact offorgetting or worrying about taking insulin correctly.Remember, there are noright or wrong answers to any of my questions. I am interested in your opinions and thoughts, whether or not they agree with anyone else. So please don’t criticize other’s comments. The group will be audio taped so that I can go back and listen to your comments. Please make sure to speak one at a time so that I can understand the tape. And please don’t just shake your head when you disagree or agree with others, as the tape cannot pick that up!

You may leave the group at any time and of course, anything you say will not be shared with your doctors or impact your treatment in any way. Please use only your first name when introducing yourself. Also, I am here to listen to you and cannot provide any medical information or guidance to you regarding diabetes treatment.

Does anyone have any questions?

A few housekeeping points – the bathrooms are located ------. The group will last about 1 1/2 hours and you can pick up your honoraria at the front desk when you leave. Help yourself to refreshments.

OK – let’s beginning with introductions.

Participant Introductions

  • First name and age
  • Occupation
  • Brief diabetes history

Warm up discussion:Can you please tell me (describe) the last timeyou had trouble or worried about taking your insulin at the right time, could not remember the time of your last dose, or the amount of insulin you took at your last dose.

  • Did you forget or were you just worried?
  • Was it a basal (long acting insulin) or a bolus (meal time, short acting) dose?
  • When was it; how long ago did this happen?
  • What were you doing at the time (were you busy, at work)?
  • What did you do about when you took your next dose/how much insulin you took (what corrective actions did you take)?
  • Were you unsure about when to take your next dose?
  • Were you unsure about how much insulin to take at your next dose?
  • Did you take more insulin than usual, less insulin than usual?
  • Did you take it sooner than you might have or later than you might have?
  • Did you speak to anyone about worrying or forgetting, or to get advice about what to do next?
  • Did you need to talk to your doctor/nurse because of the problem?
  • Did you need to go to the hospital or clinic?
  • Did you monitor your blood sugar more than you usually would?
  • If yes, how many extra times and for how long?
  • Did you have any problems with hypo- or hyperglycemia afterwards?
  • Do you think there were any negative consequences because you did not take your insulin at the right time or in the right dose?

Now let’s talk a little bit more about other timesyou might have worried about or forgotten to take your insulin properly.

  • How often do you worry about whether you have taken your insulin at the right time or in the right amount?
  • How often do you actually not remember when was the last time you took your insulin?
  • How often do you actually not remember how much insulin you took the last time you took your insulin?

Do you worry about when this happens?

If yes, what do you worry about?

Modifiers:

  • What makes it easier or harder for you to remember when you took your last dose of insulin?
  • What makes it easier or harder for you to remember exactly how much insulin you took for your last dose of insulin?

Is there anything else you would like to tell me about what it is like to have to remember when and how much insulin you took at your last injection?

Thank you.

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