PMID- 21401829
OWN - NLM
STAT- MEDLINE
DCOM- 20111222
LR  - 20220408
IS  - 1742-1241 (Electronic)
IS  - 1368-5031 (Linking)
VI  - 65
IP  - 4
DP  - 2011 Apr
TI  - A quantitative assessment of patient barriers to insulin.
PG  - 408-14
LID - 10.1111/j.1742-1241.2010.02590.x [doi]
AB  - AIM: To assess diabetes treatment preferences with a focus on patient barriers to 
      insulin treatment. MATERIALS AND METHODS: A questionnaire using indirect and 
      direct methods was administered as part of the International Diabetes Management 
      Practices Study (IDMPS). Discrete choice modelling was used to assess how product 
      attributes influence patients' preferences for diabetes treatment. A multinomial 
      logit model was used to find the odds ratio for each parameter, representing the 
      probability of selecting a chosen alternative given a choice set. This allowed 
      for the derivation of relative attribute importance, an indication of how 
      influential product attributes are in the respondents' choices. RESULTS: The 
      IDMPS questionnaire was administered to 14,033 individuals with diabetes in 18 
      countries. The majority of respondents were women (53%) and had Type 2 diabetes 
      mellitus (T2DM; 85%). Across subgroups, administration (i.e. oral vs. injection) 
      was a driver of preference. Patient preferences varied according to diabetes 
      type; individuals with T2DM assigned much higher relative importance to 
      administration than those with Type 1 diabetes mellitus (T1DM; 30.86% vs. 4.99%; 
      p<0.0001). Individuals with T2DM treated with insulin placed less importance on 
      administration than insulin-naive T2DM patients (3.09% vs. 47.48%; p<0.0001). 
      Diabetes education also had a significant effect on the priority given to 
      administration between T2DM patients who received diabetes training and those who 
      did not (28.21% vs. 33.68%, respectively; p<0.0001). CONCLUSION: The insulin 
      barriers perceived by patients with diabetes evolved with their disease 
      experience. While administration was the primary preference driver for 
      insulin-naive patients, patients were increasingly concerned with more clinically 
      relevant barriers as they gained experience with insulin. This finding suggests 
      that patients using insulin understand the importance of achieving an optimal 
      balance between safety and efficacy.
CI  - (c) 2011 Blackwell Publishing Ltd.
FAU - Casciano, R
AU  - Casciano R
AD  - Analytica International, New York, NY, USA.
FAU - Malangone, E
AU  - Malangone E
FAU - Ramachandran, A
AU  - Ramachandran A
FAU - Gagliardino, J J
AU  - Gagliardino JJ
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - India
TA  - Int J Clin Pract
JT  - International journal of clinical practice
JID - 9712381
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 1/drug therapy/*psychology
MH  - Diabetes Mellitus, Type 2/drug therapy/*psychology
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - *Patient Preference
MH  - Surveys and Questionnaires
MH  - Young Adult
EDAT- 2011/03/16 06:00
MHDA- 2011/12/23 06:00
CRDT- 2011/03/16 06:00
PHST- 2011/03/16 06:00 [entrez]
PHST- 2011/03/16 06:00 [pubmed]
PHST- 2011/12/23 06:00 [medline]
AID - 10.1111/j.1742-1241.2010.02590.x [doi]
PST - ppublish
SO  - Int J Clin Pract. 2011 Apr;65(4):408-14. doi: 10.1111/j.1742-1241.2010.02590.x.