A Prospective Study for Introducing Insulin Pens and Safety Needles in a Hospital Setting. The SANITHY Study

Abstract

BackgroundTo assess costs and safety of insulin pen devices and safety needles as compared to vial/syringes in hospitalized patients requiring insulin therapy in a General Hospital in Northern Italy.Materials and MethodsIn a prospective 9-month study, consecutive patients admitted to three Hospital Units received insulin therapy through either a traditional disposable syringe method, or pen/safety needles with dual-ended protection, or disposable safety syringes. We compared the median direct (insulin and devices) and indirect (insulin supply at discharge, insulin wastage) costs of a 10-day in-hospital insulin treatment in the 3 study groups, additionally accounting for the costs related to the observed needlestick injury rate. Patients’ safety during in-hospital stay (hypo- and hyperglycemia episodes) and satisfaction were also assessed.ResultsN=360 patients (55% men, mean age 75.6 years, 57% with DM since ≥10 years) were recruited in the study. Insulin pens had higher median direct cost than both traditional syringes (43 vs. 18 €/patient, p<.0001) and safety syringes (21.5 €/patient, p<.0001). However, when also indirect and injuries costs were taken into account, the estimated savings for using pens over traditional syringes were as high as 32 €/patient (45.8 vs. 77.6 €/patient, p-value <.0001). No differences in patients’ safety were observed. 74% and 12% of patients using pens and syringes would like to continue the method at home, respectively (p<0.0001).DiscussionA selective use of individual pre-filled pens/safety needles for patients who are likely to continue insulin therapy at home may strongly reduce hospital diabetes treatment related costs.

DropSafe safety pen needle helps to prevent accidental needlesticks after injections: results of a simulated clinical study

“…Published data report that insulin injection pen-related injury is the most common injury, accounting for 26% of all sharp injuries (Zhao et al, 2019). The introduction of SPN, with an incorporated SIPF, is an advantage over the traditional pen needles reducing the risk of injury and the spread of infectious diseases (Bossi et al, 2016; Floch, 2014; Veronesi et al, 2015). The DropSafe SPN was designed for use with pen injectors and has an automatic needle lockout after use as well as the ability to visually confirm the fluid flow through the needle and that the needle is in the lockout position and a protective sliding shield.…”

Patient-Reported Preference and Clinical Efficacy of Insulin Pen Devices With Safety Needles in Adolescents and Young Adults With Type 1 Diabetes: A Prospective Study

“…The SPN achieved more favorable scores regarding the perception of insertion, ease-of-use, frequency of insertion-associated pain, bleeding at the site of injection, bruising, and dribbling. The SANITHY study compared SPN and conventional syringes regarding direct and indirect costs, safety, and patients' satisfaction [21]. Their findings demonstrated that about 94.7% of the patients found SPN as a convenient method, 85% reported that it was safe and simple, 87.2% think that SPN might help in maintaining a good glycemic control, 89.3% would recommend SPN to other peoples with diabetes, and 74.2% will continue taking insulin at home using SPN.…”

“…We assumed that the lower incidence of needlestick injuries with SPN may stem from the mechanical characteristics of the SPN itself, SPN is loaded with a retractable shield that prevents needle exposure during and after injection [10]. However, Bossi et al [21], showed that there was no significant difference between the SPN and conventional syringes with regards to the events of in-hospital hypo-and hyperglycemia (p = 0.3).…”

Linee guida per la gestione del paziente adulto con diabete o con iperglicemia ricoverato in setting clinico non critico

“…Le evidenze scientifiche hanno mostrato effetti sostanzialmente neutri tra somministrazione sottocutanea di insulina attraverso penne o siringhe su ipoglicemie ed iperglicemie durante la degenza (31).…”