Factors affecting use of insulin pens by patients with type 2 diabetes

To assess factors that might affect patient use of insulin pens.

Patients (n = 600: 300 using vial and syringe and 300 using pen) were recruited from national panels to participate in computer-assisted telephone interviews. Measures included: demographic characteristics; diabetes treatment and self-care factors; perceptions of pen convenience, clinical efficacy, facilitation of self-care, and cost; and degree of physicians' recommending pen use.

Physician recommendation of pen use powerfully discriminated pen users from nonusers (odds ratio 135.6). Other factors that discriminated pen users included physicians' presenting pens as an option (14.1) and patient perceptions that pens facilitate diabetes self-care (20.2) and are not costly (4.8).

The physician's role in presenting the pen as an option and recommending pen use was a critical factor in patient pen use. Enhanced physician education regarding the potential benefits of pen use and encouraging physicians to discuss pen use with patients could improve diabetes outcomes.