Vial-to-Pen: Community-Based Pharmacists Converting Insulin Regimens

Overview

Journal Innov Pharm

Date 2021 May 19

PMID 34007561

Authors

Ashley N Hannings

Natasha M Michaels

Debbie Hiller

Macary Weck Marciniak

Stefanie P Ferreri

Affiliations

Soon will be listed here.

Abstract

Objective: To describe a vial-to-pen conversion program driven by community-based pharmacists and determine conversion success rate.

Methods: A report based on prescription claims was generated and identified 200 prescriptions filled for an insulin vial product and syringes. Patients were contacted by community-based pharmacists during a five-month period and were informed of the availability and potential benefits of insulin pen delivery systems (IPDS). If the patient agreed to the switch, the pharmacist contacted the prescriber to obtain a new prescription. Prescription refill records were tracked for six months post-intervention to determine whether patients who were converted remained on the IPDS.

Results: The overall vial-to-pen conversion success rate was 26% out of 121 potential conversions. In addition, 52% of patients reached were willing to switch and prescribers approved 71% of the recommendations to switch from vial-to-pen. Of the prescriptions successfully converted to an IPDS, 84% of prescriptions were still dispensed as pen products six months following the conversion.

Conclusion: to provide education on insulin delivery options and increase use of IPDS in patients with diabetes.

References

Bluml B, Watson L, Skelton J, Manolakis P, Brock K . Improving outcomes for diverse populations disproportionately affected by diabetes: final results of Project IMPACT: Diabetes. J Am Pharm Assoc (2003). 2014; 54(5):477-85. DOI: 10.1331/JAPhA.2014.13240. View

Pawaskar M, Camacho F, Anderson R, Cobden D, Joshi A, Balkrishnan R . Health care costs and medication adherence associated with initiation of insulin pen therapy in Medicaid-enrolled patients with type 2 diabetes: a retrospective database analysis. Clin Ther. 2007; 29(6 Pt 1):1294-305. DOI: 10.1016/j.clinthera.2007.07.007. View

Fera T, Bluml B, Ellis W . Diabetes Ten City Challenge: final economic and clinical results. J Am Pharm Assoc (2003). 2009; 49(3):383-91. DOI: 10.1331/JAPhA.2009.09015. View

Cranor C, Christensen D . The Asheville Project: factors associated with outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc (Wash). 2003; 43(2):160-72. DOI: 10.1331/108658003321480704. View

Peyrot M, Rubin R . Physician perception and recommendation of insulin pens for patients with type 2 diabetes mellitus. Curr Med Res Opin. 2008; 24(8):2413-22. DOI: 10.1185/03007990802278644. View

DeName B, Divine H, Nicholas A, Steinke D, Johnson C . Identification of medication-related problems and health care provider acceptance of pharmacist recommendations in the DiabetesCARE program. J Am Pharm Assoc (2003). 2008; 48(6):731-6. DOI: 10.1331/JAPhA.2008.07070. View

Cranor C, Bunting B, Christensen D . The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc (Wash). 2003; 43(2):173-84. DOI: 10.1331/108658003321480713. View

Korytkowski M, Bell D, Jacobsen C, Suwannasari R . A multicenter, randomized, open-label, comparative, two-period crossover trial of preference, efficacy, and safety profiles of a prefilled, disposable pen and conventional vial/syringe for insulin injection in patients with type 1 or 2 diabetes.... Clin Ther. 2003; 25(11):2836-48. DOI: 10.1016/s0149-2918(03)80337-5. View

Cranor C, Christensen D . The Asheville Project: short-term outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc (Wash). 2003; 43(2):149-59. DOI: 10.1331/108658003321480696. View

10.

Shelmet J, Schwartz S, Cappleman J, Peterson G, Skovlund S, Lytzen L . Preference and resource utilization in elderly patients: InnoLet versus vial/syringe. Diabetes Res Clin Pract. 2003; 63(1):27-35. DOI: 10.1016/j.diabres.2003.08.013. View

11.

Karter A, Subramanian U, Saha C, Crosson J, Parker M, Swain B . Barriers to insulin initiation: the translating research into action for diabetes insulin starts project. Diabetes Care. 2010; 33(4):733-5. PMC: 2845015. DOI: 10.2337/dc09-1184. View

12.

Pearson T . Practical aspects of insulin pen devices. J Diabetes Sci Technol. 2010; 4(3):522-31. PMC: 2901027. DOI: 10.1177/193229681000400304. View

13.

Graff M, McClanahan M . Assessment by patients with diabetes mellitus of two insulin pen delivery systems versus a vial and syringe. Clin Ther. 1998; 20(3):486-96. DOI: 10.1016/s0149-2918(98)80058-1. View

14.

Perera P, Guy M, Sweaney A, Boesen K . Evaluation of prescriber responses to pharmacist recommendations communicated by fax in a medication therapy management program (MTMP). J Manag Care Pharm. 2011; 17(5):345-54. PMC: 5013826. DOI: 10.18553/jmcp.2011.17.5.345. View

15.

Xie L, Zhou S, Wei W, Gill J, Pan C, Baser O . Does pen help? A real-world outcomes study of switching from vial to disposable pen among insulin glargine-treated patients with type 2 diabetes mellitus. Diabetes Technol Ther. 2013; 15(3):230-6. DOI: 10.1089/dia.2012.0253. View

16.

Garrett D, Bluml B . Patient self-management program for diabetes: first-year clinical, humanistic, and economic outcomes. J Am Pharm Assoc (2003). 2005; 45(2):130-7. DOI: 10.1331/1544345053623492. View

17.

Ayyagari R, Wei W, Cheng D, Pan C, Signorovitch J, Wu E . Effect of adherence and insulin delivery system on clinical and economic outcomes among patients with type 2 diabetes initiating insulin treatment. Value Health. 2015; 18(2):198-205. DOI: 10.1016/j.jval.2014.12.016. View

18.

Lee L, Li Q, Reynolds M, Engelman W . Trend analyses of insulin delivery systems in the United States. J Diabetes Sci Technol. 2011; 5(5):1116-23. PMC: 3208867. DOI: 10.1177/193229681100500512. View

19.

Coscelli C, Calabrese G, Fedele D, Pisu E, Calderini C, Bistoni S . Use of premixed insulin among the elderly. Reduction of errors in patient preparation of mixtures. Diabetes Care. 1992; 15(11):1628-30. DOI: 10.2337/diacare.15.11.1628. View

20.

Rubin R, Peyrot M . Quality of life, treatment satisfaction, and treatment preference associated with use of a pen device delivering a premixed 70/30 insulin aspart suspension (aspart protamine suspension/soluble aspart) versus alternative treatment strategies. Diabetes Care. 2004; 27(10):2495-7. DOI: 10.2337/diacare.27.10.2495. View