title: Comparison of preference for NovoPen(®) 4 with previous insulin pen treatments after 12 weeks in adult patients with type 1 and type 2 diabetes: a multicenter observational study.
abstract: BACKGROUND
  In separate randomized, crossover trials, patients with diabetes reported a preference for durable insulin pen NovoPen(®) 4 compared with NovoPen 3 and OptiClik(®).
  
  
  OBJECTIVE
  This large post-marketing observational study evaluated treatment satisfaction with NovoPen 4 versus previous treatments, which included NovoPen 3 and other devices, in insulin-treated and insulin-naive patients.
  
  
  METHODS
  During regular clinical practice in Canada, Germany, and the Netherlands, health care professionals assigned adult patients with type 1 or type 2 diabetes to treatment with insulin administered via NovoPen 4 after training according to the device's instruction manual. The primary end point was change in treatment satisfaction as determined by the Diabetes Treatment Satisfaction Questionnaire given to patients at the beginning and after 12 weeks of treatment. Two additional questionnaires were used at study end to identify why patients preferred either NovoPen 4 or their previously used insulin devices, which included NovoPen 3 and other devices (eg, HumaPen(®) Ergo and OptiPen(®) Pro). Adverse events were also recorded.
  
  
  RESULTS
  Two thousand eighteen participants (mean age, 55 years; males, 53%; type 1/type 2 diabetes, 28%/71%; mean duration of disease, 13 years; previously on insulin, 89.8%; insulin-naïve, 2.9%) participated. NovoPen 3 was previously used by 1059, HumaPen Ergo by 256, OptiPen Pro by 217, and other devices by 385 patients. Diabetes Treatment Satisfaction Questionnaire scores increased from a mean (SD) baseline of 26.5 (7.2) to 30.5 (5.0) at study end for a median difference of 4.0 (95% CI, 3.5-4.5; Wilcoxon test score: 22.7; P < 0.0001). Over 70% of patients found NovoPen 4 easier to set, read, correct, inject the dose, and change the insulin cartridge than with their previously used device (P < 0.0001). A total of 83.8% rated NovoPen 4 easier to use overall (P < 0.0001). Health care professionals (97.2%) would recommend NovoPen 4 to other patients. No adverse events associated with the device were recorded.
  
  
  CONCLUSIONS
  Patients reported a significant preference for NovoPen 4 compared with previous treatment with NovoPen 3 or other insulin device. The high ratings NovoPen 4 received for ease of use and learning could potentially lead to improved acceptance of and compliance with prescribed insulin therapy. Further study is warranted to determine the possible health benefits of using this insulin device.
authors: Isala Klinieken, Locatie Sophia, The Netherlands.
authors: Harma
authors: H
authors: Israël-Bultman
authors: Jacob
authors: J
authors: Hyllested-Winge
authors: Marcin
authors: M
authors: Kolaczynski
authors: Jörg
authors: J
authors: Steindorf
authors: Jean
authors: J
authors: Garon