Abstract
Objective:
To explore which attributes of insulin therapy drive patients’ preferences for management in Canada and Brazil.
Methods:
A qualitative design was implemented in which a total of 32 patients with type 2 diabetes from Canada and Brazil, were interviewed in one of the 4 focus groups, or 16 individual interviews. Eighteen participants (56%) were women and fourteen participants (44%) were men (15 insulin nonusers and 17 insulin users). Two focus groups of 4 participants each and 9 individual interviews were conducted in Brazil. In Canada, 2 focus groups of 4 participants each and 7 individual interviews were conducted. A framework analysis was used to analyse all data.
Results:
Brazilian participants, when considering two insulin treatments, would prefer the one that had fewer side-effects (specially hypoglycemia events), was noninjectable, had the lowest cost and was most effective. Meanwhile, Canadian participants would prefer a treatment that had fewer side-effects (specially weight gain), was less invasive, was more convenient and was most effective.
Conclusions:
Finding the insulin-delivery system and the attributes of insulin therapy that best meet patients’ preferences may lead to improved control, through improved compliance, which may ultimately reduce the financial burden of the disease and improve quality of life.
Acknowledgements
This study was supported by a grant from the University of British Columbia, Faculty of Pharmaceutical Sciences, and by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior). Dr Lynd is a Michael Smith Foundation for Health Research Scholar and a Canadian Institutes for Health Research New Investigator. Dr Marra is a Canada Research Chair in Pharmaceutical Outcomes Research. In addition, we would like to thank the staff from all diabetes education clinics in both Canada and Brazil for their co-operation during the data collection period.
Disclosure
The authors report no conflicts of interest in this work.