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Maximizing the value of validation findings to better understand treatment satisfaction issues for diabetes

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Abstract

Background

Variables associated with treatment satisfaction (TS) can be broadly categorized as precursors, ongoing treatment issues, and treatment outcomes. This study continues the validation process for the Insulin Treatment Satisfaction Questionnaire (ITSQ) while examining relationships between TS and these broader influences.

Methods

Data (N = 299) were collected in a RCT comparing safety and efficacy of inhaled vs. injectable insulin. Validation examined item and factor characteristics, reliability and validity. Regression analyses examined relationships between overall and domain specific TS and the broader influences.

Results

Patients with less previous or current treatment burden had greater TS (p < 0.001). Gender, injection fear, functioning, age, compliance and glycemic control were differentially related to TS at the beginning and end of study. Baseline satisfaction was predictive of future TS (p < 0.001). When all significant factors were examined together, lower burden with the current treatment and higher satisfaction with previous treatment continued to be key (p < 0.001) while other factors were no longer significant. Validation findings confirmed the ITSQ was psychometrically sound.

Conclusion

Over the course of treatment, some factors are associated with TS at treatment start while others are key drivers at treatment end. This suggests that TS is not a static concept.

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Abbreviations

D-FISQ:

Diabetes fear of self-injection questionnaire

DS:

Insulin delivery device satisfaction subscale

GC:

Glycemic control subscale

HC:

Hypoglycemic control subscale

HRQoL:

Health-related quality of life

IR:

Inconvenience of regimen subscale

ITSQ:

Insulin treatment satisfaction questionnaire

LF:

Lifestyle flexibility subscale

NPH:

Basal insulin

PRO:

Patient-reported outcome

SAP:

Statistical analysis plan

TS:

Treatment satisfaction

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Acknowledgment

This project and manuscript was supported by a grant from Novo Nordisk, Denmark.

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Authors and Affiliations

  1. The BROD GROUP, 219 Julia Avenue, Mill Valley, CA, 94941, USA

    Meryl Brod

  2. Novo Nordisk A/S, Global Development, Bagsvard, Denmark

    Torsten Christensen

  3. Health Research Associates, Seattle, WA, USA

    Donald Bushnell

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  1. Meryl Brod
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  2. Torsten Christensen
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  3. Donald Bushnell
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Correspondence to Meryl Brod.

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Brod, M., Christensen, T. & Bushnell, D. Maximizing the value of validation findings to better understand treatment satisfaction issues for diabetes. Qual Life Res 16, 1053–1063 (2007). https://doi.org/10.1007/s11136-007-9209-1

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