TY - JOUR
T1 - A Three-Step Data-Driven Methodology to Assess Adherence to Basal Insulin Therapy in Patients With Insulin-Treated Type 2 Diabetes
AU - Nørlev, Jannie Toft Damsgaard
AU - Kronborg, Thomas
AU - Jensen, Morten Hasselstrøm
AU - Vestergaard, Peter
AU - Hejlesen, Ole
AU - Hangaard, Stine
PY - 2023/12/29
Y1 - 2023/12/29
N2 - BACKGROUND: While health care providers (HCPs) are generally aware of the challenges concerning insulin adherence in adults with insulin-treated type 2 diabetes (T2D), data guiding identification of insulin nonadherence and understanding of injection patterns have been limited. Hence, the aim of this study was to examine detailed injection data and provide methods for assessing different aspects of basal insulin adherence.METHOD: Basal insulin data recorded by a connected insulin pen and prescribed doses were collected from 103 insulin-treated patients (aged ≥18 years) with T2D from an ongoing clinical trial (NCT04981808). We categorized the data and analyzed distributions of correct doses, increased doses, reduced doses, and missed doses to quantify adherence. We developed a three-step model evaluating three aspects of adherence (overall adherence, adherence distribution, and dose deviation) offering HCPs a comprehensive assessment approach.RESULTS: We used data from a connected insulin pen to exemplify the use of the three-step model to evaluate overall, adherence, adherence distribution, and dose deviation using patient cases.CONCLUSION: The methodology provides HCPs with detailed access to previously limited clinical data on insulin administration, making it possible to identify specific nonadherence behavior which will guide patient-HCP discussions and potentially provide valuable insights for tailoring the most appropriate forms of support.
AB - BACKGROUND: While health care providers (HCPs) are generally aware of the challenges concerning insulin adherence in adults with insulin-treated type 2 diabetes (T2D), data guiding identification of insulin nonadherence and understanding of injection patterns have been limited. Hence, the aim of this study was to examine detailed injection data and provide methods for assessing different aspects of basal insulin adherence.METHOD: Basal insulin data recorded by a connected insulin pen and prescribed doses were collected from 103 insulin-treated patients (aged ≥18 years) with T2D from an ongoing clinical trial (NCT04981808). We categorized the data and analyzed distributions of correct doses, increased doses, reduced doses, and missed doses to quantify adherence. We developed a three-step model evaluating three aspects of adherence (overall adherence, adherence distribution, and dose deviation) offering HCPs a comprehensive assessment approach.RESULTS: We used data from a connected insulin pen to exemplify the use of the three-step model to evaluate overall, adherence, adherence distribution, and dose deviation using patient cases.CONCLUSION: The methodology provides HCPs with detailed access to previously limited clinical data on insulin administration, making it possible to identify specific nonadherence behavior which will guide patient-HCP discussions and potentially provide valuable insights for tailoring the most appropriate forms of support.
KW - adherence
KW - assessment methodology
KW - connected insulin pen
KW - insulin dosing data
KW - insulin therapy
KW - type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85181189901&partnerID=8YFLogxK
U2 - 10.1177/19322968231222007
DO - 10.1177/19322968231222007
M3 - Journal article
C2 - 38158583
SN - 1932-2968
JO - Journal of Diabetes Science and Technology
JF - Journal of Diabetes Science and Technology
ER -