Jones Amy M, Hallworth Pam, Tatlock Sophi, Jensen Morten Sall, Kendal Helen, Wallace Sophie, de Laguiche Elisabeth
Patient-Centered Outcomes, Adelphi Values Ltd., Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK.
Adelphi Research, Cheshire, UK.
Diabetes Ther. 2025 Aug 20. doi: 10.1007/s13300-025-01779-8.
Basal insulin injections have historically been administered via once-daily (OD) or twice-daily (BD) injections. Once-weekly (OW) basal insulin injections have recently been developed. This study aimed to quantify the relative importance of the administration frequency in basal insulin treatment preferences of people living with T2D in Canada, Spain, France, and Japan, using a discrete choice experiment (DCE).
Best-practice guidelines for patient preference studies were followed in a three-phase study design. Phases one (targeted literature review) and two (qualitative interviews) informed the development of an attributes and levels grid. Phase three consisted of pilot interviews to evaluate the feasibility of preference survey completion and DCE tasks among adults living with T2D across Canada, France, Spain, and Japan. Hierarchical Bayesian estimation was used to estimate part-worth utilities for attribute levels, then calculate the relative importance of each attribute among other attributes tested.
The DCE survey was completed by N = 513 participants (aged 20-90; 54% male, 45% female; mean time since diagnosis: 11.6 years). Participants were split into three treatment groups: basal insulin and injectable glucagon-like peptide-1 receptor agonist (GLP-1 RA) naïve (n = 176), basal insulin naïve but with injectable GLP-1 RA experience (n = 176) and basal insulin experienced (n = 161). The administration frequency had a relative importance of 40% across the full sample, double that of any other treatment attribute tested in this study. A preference for OW administration was found relative to OD and BD. Findings were consistent across treatment groups and countries.
This study demonstrated the value and importance of administration frequency in making choices for basal insulin treatments when glycemic control is held constant. Per the pre-specified conditions, participants expressed a preference for OW basal insulin, making considered trade-offs between treatment risks (e.g., risk of a severe hypoglycemic event) and convenience (e.g., frequency of administration).
以往基础胰岛素注射采用每日一次（OD）或每日两次（BD）注射。最近研发出了每周一次（OW）基础胰岛素注射。本研究旨在通过离散选择实验（DCE），量化加拿大、西班牙、法国和日本2型糖尿病患者在基础胰岛素治疗偏好中给药频率的相对重要性。
在一项三阶段研究设计中遵循了患者偏好研究的最佳实践指南。第一阶段（针对性文献综述）和第二阶段（定性访谈）为属性和水平网格的制定提供了依据。第三阶段包括试点访谈，以评估加拿大、法国、西班牙和日本成年2型糖尿病患者完成偏好调查和DCE任务的可行性。采用分层贝叶斯估计来估计属性水平的部分价值效用，然后计算每个属性在其他测试属性中的相对重要性。
DCE调查由N = 513名参与者完成（年龄20 - 90岁；男性54%，女性45%；平均诊断后时间：11.6年）。参与者被分为三个治疗组：未使用过基础胰岛素和注射用胰高血糖素样肽-1受体激动剂（GLP-1 RA）的（n = 176）、未使用过基础胰岛素但有注射用GLP-1 RA使用经验的（n = 176）以及有基础胰岛素使用经验的（n = 161）。给药频率在整个样本中的相对重要性为40%，是本研究中测试的任何其他治疗属性的两倍。相对于OD和BD，发现对OW给药存在偏好。研究结果在各治疗组和各国之间是一致的。
本研究证明了在血糖控制保持不变时，给药频率在基础胰岛素治疗选择中的价值和重要性。根据预先设定的条件，参与者表达了对OW基础胰岛素的偏好，在治疗风险（如严重低血糖事件风险）和便利性（如给药频率）之间进行了权衡。
