title: A comparison of the handling and accuracy of syringe and vial versus prefilled insulin pen (FlexPen).
abstract: BACKGROUND
  To determine the preferable method for self-injecting insulin, we compared the handling, safety, and dose accuracy of a conventional disposable syringe and vial with FlexPen (Novo Nordisk A/S, Bagsvaerd, Denmark), a prefilled pen.
  
  
  METHODS
  Insulin therapy-naive healthcare professionals (HCPs) (n = 30), unfamiliar with insulin delivery, injected 10 U of insulin into a sponge pad using either a syringe and vial or the FlexPen, both with 30-gauge 8-mm needles, on day 1. The following day, they used the alternative method. They evaluated the handling of the two methods on device-specific questionnaires and compared overall preference on a third questionnaire. To evaluate dose accuracy, 30 insulin therapy-experienced HCPs and 20 insulin therapy-naive HCPs were asked to deliver 10 U of insulin using each method, and the amount discharged was weighed.
  
  
  RESULTS
  FlexPen was rated easier to use and overall more preferable than the syringe and vial by insulin therapy-naive HCPs (P < 0.001). The pen device was more accurate than the syringe and vial when used by experienced HCPs (mean +/- SD dose delivered, 9.91 +/- 0.11 U vs. 9.82 +/- 0.25 U, respectively; P < 0.001) and by insulin therapy-naive HCPs (9.91 +/- 0.12 U vs. 9.74 +/- 0.85 U; P < 0.001).
  
  
  CONCLUSIONS
  Insulin therapy-naive HCPs found FlexPen easier to handle and preferable to use compared to a conventional syringe and vial. Both insulin therapy-experienced and -naive HCPs were able to deliver insulin significantly more accurately with the FlexPen than with a syringe and vial (P < 0.001).
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Niigata University of Pharmacy and Applied Life Sciences, Niigata, Japan. asa-mac@m7.dion.ne.jp
authors.forename: Toshinari
authors.initials: T
authors.lastname: Asakura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Seino
authors.forename: Reiko
authors.initials: R
authors.lastname: Nakano
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Muto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Toraishi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sako
authors.forename: Miho
authors.initials: M
authors.lastname: Kageyama
authors.forename: Noriaki
authors.initials: N
authors.lastname: Yohkoh
mesh_terms: D016503:Drug Delivery Systems / Q000295:instrumentation*; D006282:Health Personnel; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007267:Injections / Q000295:instrumentation; D007328:Insulin / Q000008:administration & dosage*; D012646:Self Administration / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D013594:Syringes
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin