Evaluation of preference for a novel durable insulin pen with memory function among patients with diabetes and health care professionals

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Evaluation of preference for a novel durable insulin pen with memory function among patients with diabetes and health care professionals

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Author(s): Gerhard Klausmann ¹ , Irene Hramiak ² , Marianne Qvist ³ , Kristian Handberg Mikkelsen ³ , Xiaohui Guo ⁴

Publication date (Electronic): 05 April 2013

Journal: Patient preference and adherence

Publisher: Dove Medical Press

Keywords: diabetes, durable insulin pen, memory function, confidence, usability, patient preference

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Abstract

Background

Improving adherence to insulin treatment for better glycemic control remains a challenge in the management of diabetes. New technological aids are required to help support adherence. This study evaluated preference for the NovoPen ^® 5 (NP5), a durable insulin pen with memory function, compared with the HumaPen Luxura ^® (HPL) among patients with diabetes and health care professionals.

Methods

This crossover, multicenter usability study included insulin pen-experienced patients with diabetes and health care professionals treating patients with diabetes in Canada, China, and Germany. Participants evaluated NP5 and HPL in a randomized order by performing handling tasks in a usability test related to everyday use during a face-to-face interview. Tasks, pens, and preferences were assessed by completing a questionnaire comprised of rating and open-ended questions relating to confidence in everyday diabetes management.

Results

Overall, 300 patients with diabetes and 150 health care professionals participated in the study. Significantly more participants preferred NP5 (81%) to HPL (18%) ( P < 0.001). Also, 82% of patients with diabetes had more confidence in NP5 for managing their daily injections versus 11% with HPL ( P < 0.001), and 7% had no preference. Memory function was most helpful in giving patients with diabetes confidence about when they last injected (63%), how much insulin they last injected (62%) and improving diabetes management (55%). Participants gave higher ratings to NP5 than to HPL on all parameters relating to performing an injection (ease of handling, satisfaction when using the pen, convenience of using the pen day-to-day, quality of the pen, and the extent to which the pen meets their needs; P < 0.05 for all comparisons).

Conclusion

NP5 was preferred to HPL by most participants. Significantly more patients with diabetes had more confidence for managing daily insulin injections when using NP5, the pen with a memory function.

Most cited references 25

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Insulin adherence behaviours and barriers in the multinational Global Attitudes of Patients and Physicians in Insulin Therapy study

M Peyrot, A. Barnett, L F Meneghini … (2012)

Aims To examine patient and physician beliefs regarding insulin therapy and the degree to which patients adhere to their insulin regimens. Methods Internet survey of 1250 physicians (600 specialists, 650 primary care physicians) who treat patients with diabetes and telephone survey of 1530 insulin-treated patients (180 with Type 1 diabetes, 1350 with Type 2 diabetes) in China, France, Japan, Germany, Spain, Turkey, the UK or the USA. Results One third (33.2%) of patients reported insulin omission/non-adherence at least 1 day in the last month, with an average of 3.3 days. Three quarters (72.5%) of physicians report that their typical patient does not take their insulin as prescribed, with a mean of 4.3 days per month of basal insulin omission/non-adherence and 5.7 days per month of prandial insulin omission/non-adherence. Patients and providers indicated the same five most common reasons for insulin omission/non-adherence: too busy; travelling; skipped meals; stress/emotional problems; public embarrassment. Physicians reported low patient success at initiating insulin in a timely fashion and adjusting insulin doses. Most physicians report that many insulin-treated patients do not have adequate glucose control (87.6%) and that they would treat more aggressively if not for concern about hypoglycaemia (75.5%). Although a majority of patients (and physicians) regard insulin treatment as restrictive, more patients see insulin treatment as having positive than negative impacts on their lives. Conclusions Glucose control is inadequate among insulin-treated patients, in part attributable to insulin omission/non-adherence and lack of dose adjustment. There is a need for insulin regimens that are less restrictive and burdensome with lower risk of hypoglycaemia.

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Declaration of Helsinki. Ethical principles for medical research involving human subjects.

(2009)

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Three-year efficacy of complex insulin regimens in type 2 diabetes.

Rury R Holman, Andrew J Farmer, Melanie Davies … (2009)

Evidence supporting the addition of specific insulin regimens to oral therapy in patients with type 2 diabetes mellitus is limited. In this 3-year open-label, multicenter trial, we evaluated 708 patients who had suboptimal glycated hemoglobin levels while taking metformin and sulfonylurea therapy. Patients were randomly assigned to receive biphasic insulin aspart twice daily, prandial insulin aspart three times daily, or basal insulin detemir once daily (twice if required). Sulfonylurea therapy was replaced by a second type of insulin if hyperglycemia became unacceptable during the first year of the study or subsequently if glycated hemoglobin levels were more than 6.5%. Outcome measures were glycated hemoglobin levels, the proportion of patients with a glycated hemoglobin level of 6.5% or less, the rate of hypoglycemia, and weight gain. Median glycated hemoglobin levels were similar for patients receiving biphasic (7.1%), prandial (6.8%), and basal (6.9%) insulin-based regimens (P=0.28). However, fewer patients had a level of 6.5% or less in the biphasic group (31.9%) than in the prandial group (44.7%, P=0.006) or in the basal group (43.2%, P=0.03), with 67.7%, 73.6%, and 81.6%, respectively, taking a second type of insulin (P=0.002). [corrected] Median rates of hypoglycemia per patient per year were lowest in the basal group (1.7), higher in the biphasic group (3.0), and highest in the prandial group (5.7) (P<0.001 for the overall comparison). The mean weight gain was higher in the prandial group than in either the biphasic group or the basal group. Other adverse event rates were similar in the three groups. Patients who added a basal or prandial insulin-based regimen to oral therapy had better glycated hemoglobin control than patients who added a biphasic insulin-based regimen. Fewer hypoglycemic episodes and less weight gain occurred in patients adding basal insulin. (Current Controlled Trials number, ISRCTN51125379.) 2009 Massachusetts Medical Society

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Author and article information

Journal

Journal ID (nlm-ta): Patient Prefer Adherence

Journal ID (iso-abbrev): Patient Prefer Adherence

Title: Patient preference and adherence

Publisher: Dove Medical Press

ISSN (Electronic): 1177-889X

Publication date Collection: 2013

Publication date (Electronic): 05 April 2013

Volume: 7

Pages: 285-292

Affiliations

[1 ]Internal Medicine Diabetology Practice, Aschaffenburg, Germany

[2 ]Division of Endocrinology and Metabolism, St Joseph’s Healthcare, London, Ontario, Canada

[3 ]Novo Nordisk A/S, Soeborg, Denmark

[4 ]Department of Endocrinology, Peking University First Hospital, Beijing, People’s Republic of China

Author notes

Correspondence: Kristian Handberg Mikkelsen, Novo Nordisk A/S, Vandtåmavej 108-110, DK2860, Soeborg, Denmark, Tel +45 4444 8888, Email khmk@ 123456novonordisk.com

Article

Publisher ID: ppa-7-285

DOI: 10.2147/PPA.S41929

PMC ID: 3623548

PubMed ID: 23630416

SO-VID: 1beac1cf-0dc4-4338-b02b-1660f81e38aa

License:

This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

Patient Preference and Adherence (submit here)

Evaluation of preference for a novel durable insulin pen with memory function among patients with diabetes and health care professionals

Read this article at

Abstract

Background

Methods

Results

Conclusion

Most cited references 25

Insulin adherence behaviours and barriers in the multinational Global Attitudes of Patients and Physicians in Insulin Therapy study

Declaration of Helsinki. Ethical principles for medical research involving human subjects.

Three-year efficacy of complex insulin regimens in type 2 diabetes.

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