Simplicity, safety, and acceptability of insulin pen use versus the conventional vial/syringe device in&amp;nbsp;patients with type 1 and type 2 diabetes mellitus in Lebanon

Ramadan, Wijdan H; Khreis, Noura; Kabbara, Wissam K

doi:10.2147/ppa.s78225

Cited by 24 publications

(26 citation statements)

References 24 publications

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“…A structured questionnaire was designed by the investigators (Ripudaman Singh and Jubbin J Jacob) for data collection, modifying a similar invalidated questionnaire used by Ramadan et al among patients in Lebanon. 9 The study questionnaire was divided into seven segments. The first segment consisted of general questions about the patient’s demographics as well as the type of diabetes and its duration, the duration of insulin use, the number of times blood glucose was self-monitored and the presence of any other comorbidities.…”

Section: Methodsmentioning

confidence: 99%

A Comparison of Insulin Pen Devices and Disposable Plastic Syringes – Simplicity, Safety, Convenience and Cost Differences

Singh

Samuel

Jacob

2018

European Endocrinology

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Context: Managing diabetes efficiently demands a simple, safe, convenient and economical therapy. This study was done to understand the simplicity, safety, convenience and cost effectiveness of using pen versus syringe devices in patients on long-term insulin therapy. Design: This prospective observational study was conducted at the endocrine outpatient department of a universityaffiliated teaching hospital in North India. The investigator interviewed patients using a self-made questionnaire after obtaining consent; patients were scored based on their answers. A high score represented a poor response. A total of 90 completed questionnaires (45 from each group) were obtained. Results: Mean simplicity, safety and convenience score among the pen users was 5.31 ± 0.51, 5.4 ± 0.89 and 4.13 ± 1.04 respectively, as compared to 9.78 ± 1.43, 8.09 ± 2.02 and 8.67 ± 0.56 in syringe users respectively. The difference in these scores was statistically significant (p=0.0001). All patients felt that treatment using pen device was costlier when compared to using syringes, with pen users spending Rs1,756 per month on their insulin therapy, as compared to syringe users, who spent Rs590 per month. Among insulin pen users, 22.2% had optimal glycated haemoglobin levels (6–7.5%) as compared to 2.2% among syringe users, and this difference was statistically significant (p=0.007). Conclusions: An insulin pen is simple, safe and convenient to use, and may provide better glycaemic control. Treatment with a pen device is costlier, which may be due to the higher use of analogue insulin among pen users.

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Section: Methodsmentioning

confidence: 99%

A Comparison of Insulin Pen Devices and Disposable Plastic Syringes – Simplicity, Safety, Convenience and Cost Differences

Singh

Samuel

Jacob

2018

European Endocrinology

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“…Insulin pens may be beneficial in difficult-to-treat patient populations such as elderly individuals, patients with visual or dexterity impairments, children, and insulin-naive patients. The benefits of prefilled disposable pens have been established in a number of studies [ 39 ].…”

Section: Administrationmentioning

confidence: 99%

EADSG Guidelines: Insulin Storage and Optimisation of Injection Technique in Diabetes Management

et al. 2019

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To date, insulin therapy remains the cornerstone of diabetes management; but the art of injecting insulin is still poorly understood in many health facilities. To address this gap, the Forum for Injection Technique and Therapy Expert Recommendations (FITTER) published recommendations on injection technique after a workshop held in Rome, Italy in 2015. These recommendations are generally applicable to the majority of patients on insulin therapy, athough they do not explore alternative details that may be suitable for low- and middle-income countries. The East Africa Diabetes Study Group sought to address this gap, and furthermore to seek consensus on some of the contextual issues pertaining to insulin therapy within the East African region, specifically focusing on scarcity of resources and its adverse effect on the quality of care. A meeting of health care professionals, experts in diabetes management and patients using insulin, was convened in Kigali, Rwanda on 11 March 2018, and the following recommendations were made: (1) insulin should be transported safely, without undue shaking and exposure to high (> 32 °C) temperature environments. (2) Insulin should not be transported below 0 °C. (3) If insulin is to be stored at home for over 2 months, it should be stored at the recommended temperature of 2–8 °C. (4) Appropriate instructions should be given to patients while dispensing insulin. (5) Insulin in use should be kept at room temperature and should never be kept immersed under water. Immersing insulin under water after the vial has been pierced carries a high risk of contamination, leading to loss of potency and likelihood of causing injection abscesses. (6) The shortest available needles (4 mm for pen and 6 mm for insulin syringe) should be preferred for all patients. (7) In routine care, intramuscular injections should be avoided, especially with long-acting insulins, as it may result in severe hypoglycaemia. (8) The practice of slanting the needle excessively should be avoided as it results in sub-epidermal injection of insulin which leads to poor absorption and may cause “tattooing” of the skin and scarring. (9) In patients presenting in a wasted state, with “paper-like skin”, injections should, if possible, be initiated with pen injection devices, so as to utilise the 4-mm needle without lifting a skin fold (pinching the skin); otherwise lifting of a skin fold is required, if longer needles are utilised. (10) Reuse of needles and syringes is not recommended. However, as the reuse of syringes and needles is practiced for various reasons, and by many patients, individuals should not be given alarming messages; and usage should be limited to discarding when injections become more painful; but at any rate not to exceed reusing a needle more than 5 times. Electronic Supplementary Material The online version of this article (10.1007/s13300-019-0574-x) contains supplementary material, which is available to authorized users.

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“…Traditionally, new product development has advanced in cycles of optimizing the user interface of pen systems and (re-) assessing patient preferences [34]. Specifically, users' self-reported ratings or responses to openended questions [18,21,35,36], interviews [37,38], or observations [39][40][41] have been established as standard methods to assess patient engagement with mechanical autoinjectors or dial-anddose insulin pens [33,[42][43][44]. However, two key challenges highlight the urgent need for new methodological approaches to study usability of digitally enhanced drug delivery systems.…”

Section: Introductionmentioning

confidence: 99%

Toward a new age of patient centricity? The application of eye-tracking to the development of connected self-injection systems

Lohmeyer

Schneider

Jordi

et al. 2019

Expert Opinion on Drug Delivery

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Background: Increasing interest in digitally enhanced drug delivery tools urges both industry and academia to rethink current approaches to product usability testing. This article introduces mobile eyetracking, generating detailed contextual data about user engagement with connected self-injection systems as a new methodological approach to formative usability assessment. Methods: A longitudinal case study with a total of 35 injection-naïve participants was conducted. In three consecutive experiments, eye-tracking was applied to formative usability testing of a novel connected self-injection device. Three eye-tracking derived usability indicators were established to assess product effectiveness, efficiency, and ease of use. Results: Analysis of the data revealed events of user hesitation, process interruption and unintended action, and these occurrences could either be completely eliminated or significantly reduced throughout the process (product effectiveness). At the same time, the overall use duration decreased from 86.1 to 58.7 sec (product efficiency). Analysis revealed that product modifications successfully guided user attention to those interface elements most relevant during each task, thereby improving product easeof-use. Conclusions: The step-wise improvement in the usability indicators demonstrates that iteratively applying eye-tracking methods effectively supports the user-centered design of connected selfinjection systems. The results highlight how eye-tracking can be employed to gain an in-depth understanding of patient engagement with novel healthcare technologies. ARTICLE HISTORY

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Simplicity, safety, and acceptability of insulin pen use versus the conventional vial/syringe device in patients with type 1 and type 2 diabetes mellitus in Lebanon

Cited by 24 publications

References 24 publications

A Comparison of Insulin Pen Devices and Disposable Plastic Syringes – Simplicity, Safety, Convenience and Cost Differences

A Comparison of Insulin Pen Devices and Disposable Plastic Syringes – Simplicity, Safety, Convenience and Cost Differences

EADSG Guidelines: Insulin Storage and Optimisation of Injection Technique in Diabetes Management

Toward a new age of patient centricity? The application of eye-tracking to the development of connected self-injection systems

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