A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

Abstract

This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/107/01. The contractual start date was in June 2011. The draft report began editorial review in March 2016 and was accepted for publication in July 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by the NIH...

Pumps or Multiple Daily Injections in Pregnancy Involving Type 1 Diabetes: A Prespecified Analysis of the CONCEPTT Randomized Trial

“…The Relative Effectiveness of Pumps Over MDI and Structured Education (REPOSE) trial found that among nonpregnant adults with poorly controlled T1D (HbA 1c .7.5% or 58 mmol/mol) and no preference for pumps or MDI, both groups had improved glycemic control following diabetes self-management education (27). The REPOSE trial also reported greater improvement in diabetes treatment satisfaction and some quality of life measures, including increased dietary freedom and decreased daily hassles among pump users (28). Since CONCEPTT participants were not randomized to pump or MDI and had experienced these insulin delivery methods before enrollment, it is not surprising that overall change in patient-reported outcomes did not differ in CONCEPTT.…”

Evaluation of the application of the Diabetes Quality of Life Questionnaire in patients with diabetes mellitus

“…Studies report an improvement in glycemic control with the use of insulin, but worsening in patients' QoL (30). In addition, studies report an improvement in QoL (satisfaction with treatment) and symptoms of hypoglycemia in patients using an insulin infusion pump compared to those using multiple doses of insulin (three to four times a day) (31). The use of devices for continuous infusion of insulin was studied as an alternative to improve adherence to treatment and metabolic control.…”

Biopsychosocial Factors Associated With Satisfaction and Sustained Use of Artificial Pancreas Technology and Its Components: a Call to the Technology Field

“…Research on the impact of CGM and insulin pump use on FOH is limited, although more studies have focused on CGMs. In general, research on the impact of CGMs on FOH is mixed [41] with several studies reporting no impact of CGM [37, 42] or insulin pump [43] use on FOH. In contrast, the STAR3 study of children and adults with T1D showed significant improvement in FOH when comparing the period of time prior to sensor-augmented pump initiation and the period following initiation [44].…”