title: A Prospective Study for Introducing Insulin Pens and Safety Needles in a Hospital Setting. The SANITHY Study.
abstract: BACKGROUND
  to assess costs and safety of insulin pen devices and safety needles as compared to vial/syringes in hospitalized patients requiring insulin therapy in a General Hospital in Northern Italy.
  
  
  METHODS
  in a prospective 9-month study, consecutive patients admitted to three Hospital Units received insulin therapy through either a traditional disposable syringe method, or pen/safety needles with dual-ended protection, or disposable safety syringes. We compared the median direct (insulin and devices) and indirect (insulin supply at discharge, insulin wastage) costs of a 10-day in-hospital insulin treatment in the 3 study groups, additionally accounting for the costs related to the observed needlestick injury rate. Patients' safety during in-hospital stay (hypo- and hyperglycemia episodes) and satisfaction were also assessed.
  
  
  RESULTS
  N=360 patients (55% men, mean age 75.6 years, 57% with DM since ≥10 years) were recruited in the study. Insulin pens had higher median direct cost than both traditional syringes (43 vs. 18 ε/patient, p<.0001) and safety syringes (21.5 ε/patient, p<.0001). However, when also indirect and injuries costs were taken into account, the estimated savings for using pens over traditional syringes were as high as 32 ε/patient (45.8 vs. 77.6 ε/patient, p-value <.0001). No differences in patients' safety were observed. 74% and 12% of patients using pens and syringes would like to continue the method at home, respectively (p<0.0001).
  
  
  CONCLUSIONS
  A selective use of individual pre-filled pens/safety needles for patients who are likely to continue insulin therapy at home may strongly reduce hospital diabetes treatment related costs.
authors.affiliation: Metabolic Diseases and Diabetes Unit, Treviglio General Hospital, P.le Ospedale, 1 - 24047 Treviglio - BG - Italy. antonio_bossi@ospedale.treviglio.bg.it.
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Bossi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Veronesi
authors.forename: Carmine S
authors.initials: CS
authors.lastname: Poerio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Braus
authors.forename: Sara
authors.initials: S
authors.lastname: Madaschi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Destro
authors.forename: Bruno
authors.initials: B
authors.lastname: Ferraro
authors.forename: Lavinia
authors.initials: L
authors.lastname: Gilberti
authors.forename: Paolo
authors.initials: P
authors.lastname: Sganzerla
authors.forename: Estella M
authors.initials: EM
authors.lastname: Davis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects*; D007558:Italy; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects*; D017060:Patient Satisfaction; D013594:Syringes / Q000009:adverse effects*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin