Summers Kent H, Szeinbach Sheryl L, Lenox Sheila M
Purdue University School of Pharmacy and Pharmacy Sciences, West Lafayette, Indiana, USA.
Clin Ther. 2004 Sep;26(9):1498-505. doi: 10.1016/j.clinthera.2004.09.009.
It is not known whether preferences for the vial and syringe (VS) or the insulin injection pen device (IIPD) differ between current insulin users and nonusers. Additional benefits in treatment might be realized if preference were considered when discussing insulin use with patients initiating or changing insulin treatment.
The objective of this study was to examine respondent preferences for the VS and the IIPD between current insulin users and nonusers.
US residents with type 1 or 2 diabetes mellitus who responded to a year-2001 mail survey completed a 19-item self-administered questionnaire designed to assess respondents' expectations of attributes related to the VS and IIPD. Items were analyzed on a 5-point Likert-type scale with higher scores indicating greater agreement that attributes met expectations. Composite scores for ease of use, activity interference, and social acceptability were used to further examine differences between insulin users and nonusers regarding their preferences for the VS or IIPD. Observed differences in preferences were evaluated statistically using the chi-square test, paired Student t test, and regression analysis.
Questionnaires were received from 302 respondents, producing an adjusted response rate of 20.8%. Respondents ranged in age from 18 to 83 years (mean [SD], 52.4 [13.2] years), with 62% reporting annual income above 25,000 US dollars. Of the 242 usable responses, 99 respondents were insulin users and 143 were not. Statistical evaluation using analysis of variance revealed significant regression coefficients (P < or = 0.001) for both insulin users and nonusers for each of the 3 dimensions (ease of use, activity interference, and social acceptability with respect to preference).
Based on this survey analysis, overall preference for the IIPD appeared to be higher compared with the VS among both insulin users and nonusers. Social acceptability was the strongest predictor of preference for the IIPD. For current insulin users, social acceptability and ease of use were significant predictors of preference for the VS. For insulin nonusers, these results suggested that patient discussions about VS should emphasize activity interference and ease of use.
目前尚不清楚胰岛素使用者和非使用者对小瓶和注射器（VS）或胰岛素注射笔装置（IIPD）的偏好是否存在差异。在与开始或改变胰岛素治疗的患者讨论胰岛素使用时，如果考虑到偏好因素，可能会在治疗中实现额外的益处。
本研究的目的是调查胰岛素使用者和非使用者对VS和IIPD的偏好。
对2001年邮件调查做出回应的美国1型或2型糖尿病患者完成了一份19项的自填式问卷，旨在评估受访者对与VS和IIPD相关属性的期望。项目采用5点李克特量表进行分析，得分越高表明受访者越认同属性符合期望。使用易用性、活动干扰和社会可接受性的综合得分进一步研究胰岛素使用者和非使用者在对VS或IIPD的偏好方面的差异。使用卡方检验、配对学生t检验和回归分析对观察到的偏好差异进行统计学评估。
共收到302名受访者的问卷，调整后的回复率为20.8%。受访者年龄在18至83岁之间（平均[标准差]，52.4[13.2]岁），62%的人报告年收入超过25,000美元。在242份可用回复中，99名受访者为胰岛素使用者，143名不是。使用方差分析的统计评估显示，在三个维度（易用性、活动干扰和关于偏好的社会可接受性）中的每一个维度上，胰岛素使用者和非使用者的回归系数均具有统计学意义（P≤0.001）。
基于本次调查分析，胰岛素使用者和非使用者对IIPD的总体偏好似乎高于VS。社会可接受性是对IIPD偏好的最强预测因素。对于当前的胰岛素使用者，社会可接受性和易用性是对VS偏好的重要预测因素。对于非胰岛素使用者，这些结果表明，在与患者讨论VS时应强调活动干扰和易用性。
