title: Needle with a novel attachment versus conventional screw-thread needles: a preference and usability test among adults with diabetes and impaired manual dexterity.
abstract: BACKGROUND
  NovoTwist(®) (Novo Nordisk A/S, Bagsværd, Denmark) is an insulin pen needle that features a novel attachment and detachment system. The aim of this test was to assess overall preference and handling of NovoTwist compared with conventional screw-thread needles in people with type 1 or type 2 diabetes.
  
  
  METHODS
  One hundred twenty adults with type 1 or type 2 diabetes and manual dexterity dysfunction who were currently self-injecting with an insulin pen were included in this open-label, randomized, crossover test. Participants were stratified according to the impact that manual dexterity problems had on their ability to inject insulin (1 = no effect at all; 4 = a lot), and those rated as 1 were excluded from subanalyses because of low numbers. Following instruction, participants attached the needle to Next Generation FlexPen(®) (Novo Nordisk A/S), made an injection into a foam cushion, and detached the needle; this process was repeated three times with NovoTwist and the participant's current screw-thread needle (or NovoFine(®) [Novo Nordisk A/S]) in a random order. Responses to questions on user experience with each needle were subsequently recorded on a 6-point rating scale (1 = very difficult; 6 = very easy).
  
  
  RESULTS
  Significantly more respondents had a preference for NovoTwist (79%) compared with the conventional screw-thread needles (21%, P < 0.001). Significantly more respondents preferred NovoTwist for both ease of attachment (80%, P < 0.001) and ease of detachment (74%, P < 0.001). Most respondents found NovoTwist the most appropriate needle for performing everyday injections (71%, P < 0.001).
  
  
  CONCLUSIONS
  Such preference by patients has a positive impact on the treatment of diabetes as NovoTwist may alleviate the burden of performing everyday injections through its ease of use.
authors.affiliation: Department of Medical Endocrinology, Aarhus University Hospital, Aarhus, Denmark. BH@KI.AU.DK
authors.forename: Birtha
authors.initials: B
authors.lastname: Hansen
authors.forename: Søren K
authors.initials: SK
authors.lastname: Lilleøre
authors.forename: Gitte
authors.initials: G
authors.lastname: Ter-Borch
mesh_terms: D000368:Aged; D018592:Cross-Over Studies; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D016503:Drug Delivery Systems / Q000009:adverse effects / Q000295:instrumentation* / Q000523:psychology; D004867:Equipment Design / Q000523:psychology; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007558:Italy; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects; D057240:Patient Preference; D012646:Self Administration / Q000523:psychology; D012656:Self-Help Devices; D006113:United Kingdom
chemical_list: D007328:Insulin