Treatment satisfaction with insulin glargine in patients with diabetes mellitus in a university hospital clinic in Sweden
DOI:
https://doi.org/10.1002/edn.127Keywords:
Diabetes treatment satisfaction, insulin glargine, patient perspective, hypoglycaemiahyperglycaemiaAbstract
AbstractBackground: Few studies evaluate patients’ perspectives when a new drug is introduced to treat chronic diseases such as diabetes mellitus. The clinical role of a new insulin treatment, in terms of the relationship between higher cost and better treatment outcomes (as defined from the patient perspective) has been discussed. We sought to explore patient satisfaction with a new insulin treatment (insulin glargine). At its launch in 2002/3 it was purported to provide constant, peakless insulin release following once- or twice-daily administration, thus leading to fewer hypoglycaemic episodes while providing metabolic control equivalent to that achieved with NPH human basal insulin.
Aims: To investigate the indications used for prescription of a new drug and its clinical effects on glycosylated haemoglobin (HbA1c) levels, perceived hypoglycaemic events and patient satisfaction.
Methods: The Diabetes Treatment Satisfaction Questionnaire (Status Version, DTSQ-s), which measures satisfaction with treatment regimen, and perceived frequency of hyperglycaemia and hypoglycemia, was circulated to all living patients who had ever started treatment with insulin glargine at the Department of Endocrinology at Malmö University Hospital. Medical records of 913 patients were assessed for HbA1c levels at 0 and 12 months after starting insulin glargine therapy.
Results: Completed questionnaires were returned by 615 of 960 patients (64%) who had ever started insulin glargine. The main indications for starting treatment were physicians’ or nurses’ initiatives, desire for fewer fluctuations and improved metabolic control. HbA1c levels fell by 0.41% for patients with type 1 diabetes and by 0.68% for those with type 2 diabetes. The mean DTSQ-s score was 28.45 for satisfaction, whereas the mean perceived hypoglycaemic/hyperglycaemic events score was 3.
Conclusion: Treatment satisfaction was very high and perceived frequency of hypoglycaemia/hyperglycaemia was very low. The indications for treatment of insulin glargine are being followed in accordance with national recommendations.
Downloads
References
European Agency for the Evaluation of Medicinal Products. http://www.emea.europa.eu [Accessed 16 January 2009].
MedicalProductsAgency. //www.lakemedelsverket.se/Tpl/StartPage395.aspx [Accessed 16 January 2009].
Pharmaceutical Benefits Board. //www.lakemedelsformansnamnden.se/in-english/reimbursement-review/ [Accessed 26 January 2009].
Swedish National Board of Health and Welfare. //www.socialstyrelsen.se/en/ [Accessed 16 January 2009].
Medical Products Agency. Behand-lingsrekommendation Användning av längverkande insulinanaloger. Information frdn Lakemedelsverket Argdng 16; 2005.
Fundamental Principles of Swedish Diabetes Association. //www.diabetes.se [Accessed 3 February 2009].
Lepore M, Pampanelli S, Fanelli C, et al. Pharmacokinetics and pharma-codynamics of subcutaneous injec-don of long-acting human insulin analog glargine, NPH insulin, and ultralente human insulin and continuous subcutaneous infusion of insulin lispro. Diabetes 2000; 49: 2142–2148.
Björk Linne A, Liedholm H. Insulinglargin-en systematisk oversikt av behandlingsstudier. Inga doku-menterade fördelar med Lantus® jämfort med NPH-insulin. Lakar-tidningen 2004; 101: 2002–2007.
Wetterholtz I, Lundberg M, Berntorp K, et al. Process of Change in Diabetes Education Day-care in Malmo, Sweden. Abstract and Poster presentation at the 10th FEND Conference, Athens, Greece, September 2005. P12.
Bradley C, The Diabetes Treatment Satisfaction Questionnaire: DTSQ. In: Handbook of psychology, and diabetes: a guide to psychological measurement in diabetes research and practice. Bradley C (ed). Chur: Harwood Academic Publishers, 1994.
Wredling R, Stálhammar J, Adamson U, et al. Wellbeing and treatment satisfaction in adults with diabetes: a Swedish population based study. Qual Life Res 1995; 4:515–522.
Bradley C, Gamsu DS for the psychological well-being working group of the WHO/IDE St Vincent Declaration Action Program for Diabetes. Guidelines for encouraging psychological well-being: Report of a working group of the World Health Organization Regional Office for Europe and International Diabetes Federation European.
Region St Vincent Declaration Action Program for Diabetes. Diabet Med 1994; 11:510–516.
Swedish Nurses' Association and Gotha: Quality Indicators in Nursing. Stockholm: Gotha, 2001.
Witthaus E, Stewart J, Bradley C, Treatment satisfaction and psychological well-being with insulin glargine compared with NPH in patients with type 1 diabetes. Diabet Med 2001; 18: 619–625.
Hirsch A, Bartholomae C, Volmer T, Dimensions of quality of life in people with non-insulin-dependent diabetes. Qual Life Res 2000; 9: 207–218.
Ashwell SG, Bradley C, Stephens JW, et al. Treatment satisfaction and quality of life with insulin glargine plus insulin lispro compared with NPH insulin plus unmodified human insulin in individuals with type 1 diabetes. Diabetes Care 2008; 6: 1112–1117.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2009 Copyright © 2009 FEND
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
