Table 1.
Summary of Patient-Reported Outcome Studies of Insulin Pen versus Vial and Syringe Use in Types 1 and 2 Diabetesa
| Reference | Patient population | Summary of main PRO results | Device preference |
|---|---|---|---|
| 17 | DTNS (n = 1622) | Pen > VS for all DTSQ items, including satisfaction, convenience, flexibility, likelihood of recommendation, satisfaction to continue, and perceived frequency of hyperglycemia and hypoglycemia | Not stated |
| 25 | Children and adolescents with T1DM (n = 20) | Pen > VS for satisfaction | Pen |
| 26 | T2DM (n = 62) | Pen > VS for convenience, overall ease of use, ease of setting the insulin dose, portability, ease of storing, and improvement in lifestyle | Not stated |
| 27 | T1DM (n = 16) | Pen > VS | Not stated |
| 28 | T1DM (n = 136) and T2DM (n = 179) | Pen > VS for preference, ease of complying with insulin treatment, ease of use, ease of reading dose numbers, comfort with public use, convenience | Pen |
| 29 | T1DM (n = 10) | Pen = VS | Pen |
| 30 | T1DM (n = 77) | Pen > VS for treatment satisfaction | Not stated |
| 31 | T1DM (n = 19) | Pen > VS for convenience | Pen |
| 32 | T1DM and T2DM (n = 60) over 60 years old | Pen > VS for ease and speed of use; 90% preferred pen for future treatment | Pen |
| 33 | T1DM (n = 10) | Pen > VS for simplicity of injections and flexibility | Pen |
| 34 | Hospitalized patients with T1DM (n = 10) or T2DM (n = 65) | Pen > VS for patient recommendation and preference for continued use | Not stated |
| 35 | T1DM (n = 27) | Pen > VS for preference, ease of use, and quicker to use | Pen |
| 36 | T1DM (n = 40) | 95% of patients chose to continue with pen rather than VS | Pen |
| 37 | T2DM (n = 86) | Pen > VS | Pen |
| 38 | T1DM and T2DM (n = 1310) | Pen > VS for injection pain, social acceptability, convenience, ease of use, flexibility, and overall preference | Pen |
| 39 | Children and adolescents with T1DM (n = 158) | Pen > VS for injection pain | Not stated |
| 40 | T1DM (n = 72) | Pen > VS for QOL | Not stated |
| 41,42 | T1DM (n = 16) | 81% of patients chose to continue with pen rather than VS | Pen |
| 43 | T1DM (n = 6) or T2DM (n = 12) | More patients preferred VS (50%) than pens (44%) for future use | VS |
| 44 | T1DM (n = 14) or T2DM (n = 218) | Pen > VS | Pen |
| 45 | T1DM (n = 50) | 96% of patients chose to continue with pen rather than VS | Pen |
| 46 | T2DM (n = 78) | Pen > VS for injection pain, acceptance, ease of setting and drawing up the dose, and overall preference | Pen |
| 47 | T1DM (n = 19) | Pen > VS for ease and speed of use | Pen |
| 48 | T1DM (n = 14) or T2DM (n = 107) | Patient preference questionnaire: pen > VS for preference, ease of use, confidence in glycemic control, more stable, more discreet in public, confidence in injecting correct dose and in setting dose, ease of reading dose; on all DTSQ items, no major differences between pen and VS | Pen |
| 16 | T1DM (n = 4) and T2DM (n = 61) | Pen > VS for QOL | Not stated |
| 49 | T1DM and T2DM (n = 72; previous VS users) | Pen > VS for convenience, comfort, and ease of use; 74% of syringe users preferred to continue with the pen | Pen |
| 23 | T2DM (n = 349) | Pen > VS for treatment satisfaction | Not started |
| 50 | T1DM (n = 78) | 95% of patients preferred pen over VS and continued with the pen | Pen |
| 51 | Children and adolescents with T1DM (n = 40) | 95% preferred pen over VS | Pen |
| 52 | T1DM and T2DM (n = 100) | 100% of patients preferred pen over VS | Pen |
| 53 | T2DM (n = 372) | Pen > VS for convenience, flexibility, perceived clinical efficacy, QOL, and preference | Not stated |
| 54 | DTNS (n = 16) | Pen > VS for ease and speed of use | Not stated |
| 55 | Adolescents (aged 12–18 years) with T1DM (n = 19) | Pen-based basal–bolus insulin regimen preferred by all patients over previous syringe-based twice-daily insulin regimen | Not stated |
| 56 | T1DM (n = 93; women in pregnancy) | Pen > VS for ease of use | Not stated |
| 57 | T1DM (n = 37) | Pen > VS for flexibility | Not stated |
| 58 | T1DM (n = 21) | Pen > VS portability, speed of use, and overall preference | Not stated |
| 59 | T1DM and T2DM (n = 70) | 74% preferred to continue using pen; 75% expressed preference for the pen over VS | Pen |
| 60 | T1DM and T2DM (n = 330) | Pen > VS for convenience and ease of use | Not stated |
| 61 | T1DM and T2DM (n = 99 insulin users; n = 143 insulin nonusers) | Overall preference appeared to be higher for pens compared with VS | Not stated |
| 62 | T1DM (n = 18) | Pen > VS for flexibility of meal times and an increased experience of freedom | Not stated |
| 63 | Children and adolescents with T1DM (n = 15) | Pen > VS for convenience, ease of use, portability, discreetness, and QOL | Pen |
| 64 | Homeless patients with T1DM (n = 2) or T2DM (n = 21) | Pen > VS for convenience, ease of use, and perceived dose accuracy | Not stated |
a
Study participants were adults unless otherwise specified. >, favored over; =, no significant difference between insulin pen and vial/syringe; DTNS, diabetes type not specified; DTSQ, diabetes treatment satisfaction questionnaire; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus; VS, vial and syringe. Studies of discontinued devices were excluded from this table.