OBJECTIVES: Information technology is an essential tool to improve patient safety and the quality of care, and to reduce healthcare costs. There is a scarcity of large sustainable implementations in developing countries. The objective of this paper is to review the challenges faced by developing countries to achieve sustainable implementations in health informatics and possible ways to address them. METHODS: In this non-systematic review of the literature, articles were searched using the keywords medical informatics, developing countries, implementation, and challenges in PubMed, LILACS, CINAHL, Scopus, and EMBASE. The authors, after reading the literature, reached a consensus to classify the challenges into six broad categories. RESULTS: The authors describe the problems faced by developing countries arising from the lack of adequate infrastructure and the ways these can be bypassed; the fundamental need to develop nationwide e-Health agendas to achieve sustainable implementations; ways to overcome public uncertainty with respect to privacy and security; the difficulties shared with developed countries in achieving interoperability; the need for a trained workforce in health informatics and existing initiatives for its development; and strategies to achieve regional integration. CONCLUSIONS: Central to the success of any implementation in health informatics is knowledge of the challenges to be faced. This is even more important in developing countries, where uncertainty and instability are common. The authors hope this article will assist policy makers, healthcare managers, and project leaders to successfully plan their implementations and make them sustainable, avoiding unexpected barriers and making better use of their resources.
Administrative Personnel ; Consensus ; Delivery of Health Care ; Developed Countries ; Developing Countries* ; Health Care Costs ; Health Manpower ; Health Planning ; Hope ; Humans ; Informatics* ; Medical Informatics ; Patient Safety ; Privacy ; Public Health Informatics ; Uncertainty

Diabetes mellitus is a major health problem with increasing prevalence at a global level. The discovery of insulin in the early 1900s represented a major breakthrough in diabetes management, with further milestones being subsequently achieved with the identification of glucagon-like peptide-1 (GLP-1) and the introduction of GLP-1 receptor agonists (GLP-1 RAs) in clinical practice. Moreover, the subcutaneous delivery of biotherapeutics is a well-established route of administration generally preferred over the intravenous route due to better patient compliance and prolonged drug absorption. However, current subcutaneous formulations of GLP-1 RAs present pharmacokinetic problems that lead to adverse reactions and treatment discontinuation. In this review, we discuss the current challenges of subcutaneous administration of peptide-based therapeutics and provide an overview of the formulations available for the different routes of administration with improved bioavailability and reduced frequency of administration.