Perceived medication benefits and their association with interest in using inhaled insulin in type 2 diabetes: a model of patients' cognitive framework

Mark Peyrot^1,2, Richard R Rubin^2,3
1Department of Sociology, Loyola University, MD, USA; ²Department of Medicine, ³Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA

Objective: To examine predictors of patient perceived relevance of different diabetes medication benefits, and to determine how medication benefit ratings of an inhaled insulin were associated with evaluation of, and interest in that inhaled insulin.
Methods: The study was an Internet survey of a US sample (n = 1094) of adults with type 2 diabetes using different medication regimens. Patients were given a brief description of potential clinical benefits and administration procedures for the inhaled insulin described in this study (based on MannKind Corporation's Technosphere insulin). Measures included indicators of medication benefits, needs and relevance, benefit ratings and overall evaluation of the studied inhaled insulin relative to current medication, and interest in the study medication. Multivariate regression assessed significant (P < 0.05) independent associations, controlling for demographic and disease characteristics.
Results: Relevance of potential medication benefits (avoidance of hyperglycemia, hypoglycemia, weight gain, discomfort/inconvenience) was significantly associated with objective and subjective indicators of patients' needs. Most need indicators were associated only with the specific benefit to which they apply; concerns about weight and lifestyle were associated with multiple benefits. Ratings of the studied inhaled insulin for avoiding postprandial hyperglycemia and discomfort/inconvenience were associated with overall evaluation of and interest in the inhaled insulin described in this study; rating of this medication for avoiding weight gain was associated with overall evaluation ratings.
Conclusions: Relevance of different potential benefits was based on objective and subjective indicators of need. Perceived efficacy of the inhaled insulin described in this study for avoiding postprandial hyperglycemia and discomfort/inconvenience were the benefits most strongly related to the evaluation of and interest in this medication.

Keywords: type 2 diabetes, inhaled insulin, medication benefits, patient preference