title: Simplicity, safety, and acceptability of insulin pen use versus the conventional vial/syringe device in patients with type 1 and type 2 diabetes mellitus in Lebanon.
abstract: BACKGROUND
  The aim of the study was to evaluate the simplicity, safety, patients' preference, and convenience of the administration of insulin using the pen device versus the conventional vial/syringe in patients with diabetes.
  
  
  METHODS
  This observational study was conducted in multiple community pharmacies in Lebanon. The investigators interviewed patients with diabetes using an insulin pen or conventional vial/syringe. A total of 74 questionnaires were filled over a period of 6 months. Answers were entered into the Statistical Package for Social Sciences (SPSS) software and Excel spreadsheet. t-test, logistic regression analysis, and correlation analysis were used in order to analyze the results.
  
  
  RESULTS
  A higher percentage of patients from the insulin pen users group (95.2%) found the method easy to use as compared to only 46.7% of the insulin conventional users group (P 0.001, relative risk [RR]: 2.041, 95% confidence interval [CI]: 1.178-3.535). Moreover, 61.9% and 26.7% of pen users and conventional users, respectively, could read the scale easily (P 0.037, RR 2.321, 95% CI: 0.940-5.731), while 85.7% of pen users found it more convenient shifting to pen and 86.7% of the conventional users would want to shift to pen if it had the same cost. Pain perception was statistically different between the groups. A much higher percentage (76.2%) of pen users showed no pain during injection compared to only 26.7% of conventional users (P 0.003, RR 2.857, 95% CI: 1.194-6.838).
  
  
  CONCLUSIONS
  The insulin pen was significantly much easier to use and less painful than the conventional vial/syringe. Proper education on the methods of administration/storage and disposal of needles/syringes is needed in both groups.
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon.
authors.forename: Wijdan H
authors.initials: WH
authors.lastname: Ramadan
authors.affiliation: King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: Noura A
authors.initials: NA
authors.lastname: Khreis
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon.
authors.forename: Wissam K
authors.initials: WK
authors.lastname: Kabbara
keywords: conventional vial/syringe; diabetes; hypoglycemia; insulin pen; needle phobia; pain perception; secretagogue
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