The Diabetes Treatment Satisfaction module was developed independently by Phase V Technologies using a compendium of existing diabetes satisfaction items and incorporating new items developed from a series of focus group studies with persons with type 1 and type 2 diabetes experienced with newer oral hypoglycemic agents, insulin formulations, and inhaled insulin technology. Item pool selection, psychometric analysis, and field-testing was conducted by Phase V Technologies.
The following constructs were evaluated using the long-form diabetes treatment satisfaction module including:
- Life Interference
- Acceptance of Negative Aspects (including side effects, stress, hassle)
- Acceptance of Positive Aspects (including effectiveness, ease of use, comfort)
- Overall Patient Preference (compared to other treatments).
The treatment satisfaction battery comprises four sections dealing with diabetes treatment involving 1) any form, 2) insulin (regardless of delivery), 3) insulin injections and 4) insulin inhalers.
Overall Satisfaction With Treatment
This 72-item section assesses satisfaction with diabetes treatment in general and is not targeted towards any one kind of treatment or delivery system. The subscales included:
- Advocacy: 2 items on recommending and advocating the treatment to other persons with diabetes, including family and friends.
- Burden: 14 items concerning multiple aspects of burden of the therapeutic regimen including adherence, diet, exercise, burden for performing daily activities, social activities and enjoying life.
- Convenience: 6 items relating to ability to remember taking medication, overall convenience, being pleased with convenience, amount of time required to manage diabetes.Efficacy: 3 items on the patient's perception of the treatment's ability to control blood sugar.
- Flexibility: 4 items on how flexible the treatment is for scheduling and allowing variability in meals and overall flexibility.
- General Satisfaction: 5 items on general satisfaction and being pleased with current medication.
- Hassle: 8 items specific to the amount of bother and hassle of the regimen including dosing, treatment supplies, carrying supplies, supply disposal, pain and discomfort, and worries about hypoglycemia and hyperglycemia.
- Interference: 11 items concerning how much the diabetes medication interferes with daily routine, meals, recreation, family life, sleep schedules, energy levels, making plans, traveling, having fun and overall quality of life.
- Pain: 3 items concerning pain and discomfort.
- Preference: 2 items rating how strong the desire to search out other regimens that might be better and to continue on current regimen.
- Side effects: 5 items concerning gaining weight, unpleasant feelings, distress with hypoglycemia and hyperglycemia.
- Social: 9 items rating the treatment's interference with social interactions with family and friends, travel, having fun, and problems in performing work and social roles.
Satisfaction with Insulin
These 7 items assess satisfaction with insulin without regard for specific delivery system and include content on convenience, burden, social interactions and general satisfaction.
Satisfaction with Injections
These 6 items assess satisfaction with injection as a delivery system and include content on convenience, ease, efficacy, advocacy, and general satisfaction.
Satisfaction with Inhaler
These 12 items assesses satisfaction with the inhaler as a delivery system and includes content on convenience, burden, efficacy, advocacy, preference, general satisfaction, pain, and flexibility.
These 13 items assess a direct comparison of preference for either inhaled or injected insulin and covers ease, convenience, flexibility, efficacy, social, and preference.