ArticleAdvances in therapy2015
Characteristics Relating to Adherence and Persistence to Basal Insulin Regimens Among Elderly Insulin-Naïve Patients with Type 2 Diabetes: Pre-Filled Pens versus Vials/Syringes.
Article in Advances in therapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 41 citations in OpenAlex.
- Dose Accuracy, Injection Force, and Usability Assessment of a New Half-Unit, Prefilled Insulin Pen.Journal of diabetes science and technology · 2018Trial
- Impact of Injection Speed, Volume, and Site on Pain Sensation.Journal of diabetes science and technology · 2018Trial
- Basal Insulin Adherence in Patients with Type 2 Diabetes Mellitus in Routine Clinical Practice in Spain: Clinical and Economic Impact.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Article
- 7. Diabetes Technology: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Content Validity of the Hemophilia Device Handling and Preference Assessment Questionnaire - A Cognitive Debrief Study in Patients with Hemophilia and Their Caregivers.Patient preference and adherence · 2025Article
- 7. Diabetes Technology: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- 7. Diabetes Technology: Standards of Care in Diabetes-2024.Diabetes care · 2024Review
- Factors Affecting Performance of Insulin Pen Injector Technology: A Narrative Review.Journal of diabetes science and technology · 2023Review
- Comparison of simplicity, convenience, safety, and cost-effectiveness between use of insulin pen devices and disposable plastic syringes by patients with type 2 diabetes mellitus: a cross-sectional study from Bangladesh.BMC endocrine disorders · 2023Article
- 7. Diabetes Technology: Standards of Care in Diabetes-2023.Diabetes care · 2023Review
- Adherence and Persistence to Insulin Therapy in People with Diabetes: Impact of Connected Insulin Pen Delivery Ecosystem.Journal of diabetes science and technology · 2022Review
- The Review of Insulin Pens-Past, Present, and Look to the Future.Frontiers in endocrinology · 2022Review
- Pens versus syringes to deliver insulin among elderly patients with type 2 diabetes: a randomized controlled clinical trial.Diabetology & metabolic syndrome · 2021Article
- Reasons for discontinuing insulin and factors associated with insulin discontinuation in patients with type 2 diabetes mellitus: a real-world evidence study.Clinical diabetes and endocrinology · 2021Article
- Suitable Use of Injectable Agents to Overcome Hypoglycemia Risk, Barriers, and Clinical Inertia in Community-Dwelling Older Adults with Type 2 Diabetes Mellitus.Drugs & aging · 2019Review
- Injectable Antihyperglycemics: A Systematic Review and Critical Analysis of the Literature on Adherence, Persistence, and Health Outcomes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Review
- Treatment adherence to pegvisomant in patients with acromegaly in Spain: PEGASO study.Pituitary · 2019Article
- Article
- Bridging the Gap Between Self-Reported and Claims-Derived Adherence Measures for Basal Insulin Among Patients with Type 2 Diabetes Mellitus.Advances in therapy · 2019Article
- Real-world insulin therapy in German type 2 diabetes mellitus patients: patient characteristics, treatment patterns, and insulin dosage.Diabetes, metabolic syndrome and obesity : targets and therapy · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPrevious studies have found higher rates of adherence in patients with type 2 diabetes mellitus (T2DM) using insulin pens compared to vial and syringe administration; however, little evidence is available to support this observation in elderly patients.
methodsThis was a retrospective claims database analysis of a predominantly elderly Medicare Advantage with Prescription Drug (MAPD) insurance population consisting of 3172 insulin-naïve patients with T2DM who initiated basal insulin using pre-filled pens or vial and syringe ('vial'). The index date was defined by the first pharmacy claim for basal insulin. Adherence, measured as proportion of days covered (PDC) and medication possession ratio (MPR), and persistence were evaluated in a 12-month follow-up period using an adjusted days' supply. Multivariate regression analyses and a Cox proportional hazards model were used to identify characteristics associated with adherence and non-persistence, respectively, and compare findings between the pen and vial groups.
resultsThe pen cohort was slightly younger than the vial cohort (69.4 vs. 70.1 years, respectively; P = 0.0338). Similar proportions of male patients (53.3% vs. 56.8%; P = 0.0529) occurred in both cohorts, and lower Deyo-Charlson Comorbidity Index (4.4 vs. 5.0; P < 0.0001) was found for the pen cohort. Adjusted mean PDC was significantly higher in the pen cohort than the vial cohort (0.67 vs. 0.50; P < 0.001), as was mean MPR (0.75 vs. 0.57; P < 0.0001). Adjusted odds for adherence (PDC ≥ 80%) showed a positive association with use of an insulin pen (odds ratio = 2.19, 95% CI: 1.86-2.59). The adjusted risk of non-persistence (discontinuation) was significantly lower (58%) in the pen cohort relative to the vial cohort (hazard ratio = 0.42, 95% CI: 0.38-0.45). Key limitations include assumptions related to accuracy and comprehensiveness of claims data, and specifically days' supply data used to measure insulin adherence.
conclusionThese findings suggest that pen devices improved insulin therapy adherence in a primarily elderly MAPD population with T2DM.
fundingNovo Nordisk Pharmaceuticals, Inc.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.