People With Diabetes and Caregivers Prefer Rescue Glucagon Treatment With a Wider Storage Temperature Range and a Nasal Administration, When Efficacy is Similar: A Discrete Choice Experiment in Spain.

Autor:	Mitchell BD; Eli Lilly and Company, Indianapolis, IN, USA., Rentz AM; Evidera, Bethesda, MD, USA., Kummer S; Evidera, Bethesda, MD, USA., Yan Y; Eli Lilly and Company, Indianapolis, IN, USA., Heidenreich S; Evidera, London, UK., Krucien N; Evidera, London, UK., Artime E; Eli Lilly and Company, Indianapolis, IN, USA., Osumili B; Eli Lilly and Company, Indianapolis, IN, USA., Rubio M; Eli Lilly and Company, Indianapolis, IN, USA., Gelhorn HL; Evidera, Bethesda, MD, USA.
Jazyk:	angličtina
Zdroj:	Journal of diabetes science and technology [J Diabetes Sci Technol] 2023 Nov; Vol. 17 (6), pp. 1623-1633. Date of Electronic Publication: 2022 May 09.
DOI:	10.1177/19322968221095882
Abstrakt:	Background: Conventional injectable glucagon (IG) and nasal glucagon (NG), both having similar efficacy, are two options for the emergency treatment of severe hypoglycemia in Spain. This study elicited the effect of changes in key attributes on preferences for NG and IG medication profiles of people with diabetes and caregivers in Spain. Methods: The relative attribute importance (RAI) that participants placed on glucagon preparation, preparation and administration time, delivery method, recovery time, device size, storage temperature, and headache risk was estimated from an online discrete choice experiment. In addition, patients and caregivers were presented with NG and IG profiles that included rates of successful administration; the proportion of participants choosing each profile was summarized. Results: The analysis included 276 adults with diabetes (65% type 1) and 270 caregivers (49% type 1). Overall mean age was 40 years; 51% were female. The most important attributes were storage temperature (RAI [95% confidence interval] = 27.3% [22.9-32.2]) and delivery method (17.4% [13.1-21.9]). Headache risk (16.2% [11.8-20.7]), time to prepare and administer (14.5% [10.1-18.8]), glucagon preparation (11.4% [6.8-15.8]), recovery time (8.9% [4.3-13.3]), and device size (4.3% [0.3-8.8]) were also relevant. When comparing medication profiles, significantly more participants (78%) preferred NG over IG profiles ( P < .001). Conclusion: Adults with diabetes and caregivers prefer a glucagon treatment with a higher rate of successful administration, wider storage temperature, and nasal delivery method, when efficacy is similar. Participants favored NG over conventional IG as a rescue medication for severe hypoglycemia. This information may help decision-making by payers and treatment discussions between health care professionals and patients. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The study sponsor was involved in the design of the study and analysis, interpretation of the data, and review and approval of the manuscript. Anne M. Rentz, Sebastian Heidenreich, Nicolas Krucien, and Heather L. Gelhorn are employed by Evidera, which provides consulting and other research services to pharmaceutical, device, government, and nongovernment organizations. As Evidera employees, they work with a variety of companies and organizations and are expressly prohibited from receiving any payment or honoraria directly from these organizations for services rendered.Shannon Kummer was an employee of Evidera at the time of the study.Beth Mitchell, Yu Yan, Esther Artime, Beatrice Osumili, and Miriam Rubio are employed by and own stock in Eli Lilly and Company.The authors report no other conflicts of interest in this work.All aspects of the study design, interpretation, and decision to submit for publication were determined by the authors.
Databáze:	MEDLINE
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