Patients Use Exenatide Pen More Successfully With Educator-led Training

Saturday, August 13, 2005

Research Presentation

Speakers
Susan Barlow, RD, CDE
Patricia Johnson, MA, RN, CDE

Reported by Joelle Escoffery, PhD

This presentation focused on research related to the functionality and usability of the exenatide injection pen. This device was specifically designed for exenatide use. The pen delivers fixed doses of exenatide (either 5 μg or 10 μg) and provides a 1 month supply (60 injections). Unlike available insulin pens, the exenatide pen does not require priming after initial set up.

Participants were injection naïve patients with type 2 diabetes. They were taking 1 or more oral medications, and they ranged in age from 21-75 years. Additionally, the sample was selected such that 30% of participants had a high school degree or less, and 10% of participants were left-handed (to reflect national averages). Patients were assigned to receive traditional care (access to both an instruction manual and a simulated call center) or traditional care plus training from a diabetes educator.

Participants were observed while performing the following tasks: 1) attaching a new needle to the pen, 2) performing the initial set-up, 3) dialing the dose, 4) administering the injection, and 5) resetting the pen for the next dose. The primary outcomes of this study were successful usability and acceptability from naïve patients, with successful usability defined as successful injection administration by at least 50% of untrained participants.

The results demonstrated that over 50% of patients in the naïve group were able to successfully complete all 5 steps required to administer an injection of exenatide. The lowest success rate was observed among the untrained participants when trying to perform the initial pen set up (56% success rate). On the other 4 tasks, the naïve participant group achieved a 70% success rate or higher. The educator-trained group achieved a success rate of over 80% on all 5 tasks, and their success rate was consistently higher than their counterparts in the naïve group.

Based on patient feedback from this study, alterations were made to the user guide that should further increase success rate. The results demonstrate that this device is usable and acceptable by patients, and that educator training increases the likelihood of successful use.