846-P: Patients with T2D Are Willing To Do More than Their HCPs Expect to Overcome Therapeutic Inertia

Abstract

Few patients on basal insulin (BI) reach suggested glycemic goals despite repeated dose titration attempts and availability of other support services/medications. An online quantitative survey was used to explore differences between patient and healthcare provider (HCP) priorities and perceptions of therapeutic regimens and approaches. It was completed by 305 T2D patients on BI >1 year and 240 HCPs. Patient and HCP preferences were compared regarding treatment priorities, estimated time to reach A1C goals, impact of not reaching goals, and willingness to change treatment and do more to reach goals. Results showed the similarities and differences in patient and HCP views and priorities. Top patient priorities were to: maintain goals long term (62%), stay healthy (44%), and avoid weight gain (43%) vs. HCPs: avoid side effects (55%), consider treatment affordability (53%), and maintain goals long term (45%). It took longer than expected to meet A1C goals (35% each group); of patients, 49% expected goals would not be met; 61% wanted to reach goals faster; 80% were frustrated by slow progress to reach goals. More patients expected to reach goals in 1-5 years (42% vs. HCPs 16%); both groups wanted to reach goals in 6-12 months. More patients would try harder to reach goals than HCPs expected (37% vs. 16%), be willing to visit their HCP more often (42% vs. 17%), consider treatment changes (40% vs. 18%), and try a different injectable (45% vs. 34%). Within 12 months of starting BI, 17% of patients (vs. 68% of HCPs) expected no treatment addition. More endocrinologists (29% vs. PCPs 16%) anticipated titrating BI dose ≥100 U/day. In patients, 61% felt frustrated not reaching goals on BI, whereas HCPs estimated only 36% of patients would be frustrated. In summary, patients are willing to do more than their HCPs expect. A better understanding of the disparate perceptions and preferences of patients and HCPs could enhance outcomes for T2D patients on BI not reaching glycemic goals and reduce unwarranted complications. Disclosure J. Chamberlain: Speaker's Bureau; Self; Merck & Co., Inc., Novo Nordisk Inc., Sanofi-Aventis. R. Wood: Other Relationship; Self; Multiple companies in the diabetes field (>10 companies). M. Roberts: None. S. Edelman: Advisory Panel; Self; BrightSight, InPen, Lexicon Pharmaceuticals, Inc., Novo Nordisk Inc. Board Member; Self; Senseonics. Speaker's Bureau; Self; AstraZeneca, Lilly Diabetes, MannKind Corporation, Merck Foundation, Sanofi-Aventis. Funding Sanofi U.S.