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Patients Prefer Disposable Insulin-Injection Pen to Conventional Vial/Syringe Delivery Method

Prefilled, disposable pens are comparable to the traditional vial/syringe insulin delivery method in efficacy and safety, but patients with diabetes prefer the pen overall, according to a study from the University of Pittsburgh Medical Center, Pennsylvania, United States.

"Prefilled, disposable insulin-injection devices may have the notable advantage of simplicity, with minimal training and attention required," writes Mary Korytkowski, MD.

Dr. Korytkowski and colleagues performed an open-label, 2-period crossover trial to compare patient preference, efficacy and safety of the prefilled, disposable pen with the conventional vial/syringe insulin delivery method. The study included 121 patients (mean age, 57±12.4 years; 62 males) 14 with type 1 and 107 with type 2 diabetes mellitus.

All patients were syringe/vial users and had never used another method of insulin delivery. After a 4-week run in period, patients were randomly assigned to use either a prefilled, disposable pen device or the vial/syringe method to administer a mixture of 70% insulin aspart protamine suspension and 30% insulin aspart for 4 weeks (NovoLog Mix 70/30). Patients were then switched to the opposite delivery method for the following 4 weeks.

Seventy-four percent of the 103 patients who completed the trial found using the pen device to be easier overall, as determined by a patient preference questionnaire given at the end of the study. Specifically, 85% found the insulin dose scale easier to read, 73% felt more confident in the accuracy of the insulin dose delivered, and 85% felt that the pen was more discreet to use in a public place.

The researchers found a statistically significant improvement in glycaemic control during the entire study, with a 0.3% average reduction in glycosylated haemoglobin values (P < .05). No differences in glycaemic control were detected between the two devices, and safety profiles were also found to be comparable.

"This study provides additional evidence that an alternative injection device technology may meet with more positive patient feelings than the vial/syringe method, even among patients who were already generally satisfied using the latter," the researchers conclude.

Clin Ther 2003 Nov;25:11:2836-48. "A multicenter, randomized, open-label, comparative, two-period crossover trial of preference, efficacy, and safety profiles of a prefilled, disposable pen and conventional vial/syringe for insulin injection in patients with type 1 or 2 diabetes mellitus"

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