Impact of injection speed and volume on perceived pain during subcutaneous injections into the abdomen and thigh: A single-centre, randomized controlled trial

Diabetes, Obesity and Metabolism

Volumn 16, Issue 10, 2014, Pages 971-976

  Heise, Tim ^a   Nosek, L ^a   Dellweg, S ^a   Zijlstra, E ^a   Praestmark K A ^b   Kildegaard, J ^b   Nielsen, G ^b   Sparre, T ^b  

^a Profil   (Germany)

^b NOVO NORDISK A S   (Denmark)

Author keywords

Diabetes; Injection speed; Injection volume; Subcutaneous injections

Indexed keywords

GLUCAGON LIKE PEPTIDE 1 RECEPTOR AGONIST; INSULIN; ANTIDIABETIC AGENT;

ABDOMEN; ADULT; AGED; APPLICATION SITE ERYTHEMA; ARTICLE; CONTROLLED STUDY; DISEASE DURATION; DOUBLE BLIND PROCEDURE; DRUG INJECTION VOLUME; FEMALE; HUMAN; INJECTION; INJECTION SITE; INJECTION SITE BLEEDING; INJECTION SITE CONTUSION; INJECTION SITE EDEMA; INJECTION SITE PAIN; INJECTION SPEED; INSULIN DEPENDENT DIABETES MELLITUS; MAJOR CLINICAL STUDY; MALE; NOCICEPTION; NON INSULIN DEPENDENT DIABETES MELLITUS; PAIN ASSESSMENT; POSITIVE AND NEGATIVE AFFECT SCHEDULE; PSYCHOLOGICAL WELL BEING; RANDOMIZED CONTROLLED TRIAL; THIGH; VISUAL ANALOG SCALE; ADVERSE EFFECTS; DIABETES MELLITUS, TYPE 1; DIABETES MELLITUS, TYPE 2; MIDDLE AGED; PAIN; PAIN MEASUREMENT; PATIENT ATTITUDE; PROCEDURES; PSYCHOLOGY; REPRODUCIBILITY; SUBCUTANEOUS DRUG ADMINISTRATION; TREATMENT OUTCOME;

ABDOMEN; ADULT; AGED; DIABETES MELLITUS, TYPE 1; DIABETES MELLITUS, TYPE 2; DOUBLE-BLIND METHOD; FEMALE; HUMANS; HYPOGLYCEMIC AGENTS; INJECTIONS, SUBCUTANEOUS; INSULIN; MALE; MIDDLE AGED; PAIN; PAIN MEASUREMENT; PAIN PERCEPTION; PATIENT ACCEPTANCE OF HEALTH CARE; REPRODUCIBILITY OF RESULTS; THIGH; TREATMENT OUTCOME;

EID: 84912073262     PISSN: 14628902     EISSN: 14631326     Source Type: Journal    
DOI: 10.1111/dom.12304     Document Type: Article

References (29)

1. Borah BJ, Huang X, Zarotsky V, Globe D. Trends in RA patients' adherence to subcutaneous anti-TNF therapies and costs. Curr Med Res Opin 2009; 25: 1365-1377.
2. Chan KE, Thadhani RI, Maddux FW. No difference in bleeding risk between subcutaneous enoxaparin and heparin for thromboprophylaxis in endstage renal disease. Kidney Int 2013; 84: 555-561.
3. Devonshire V, Lapierre Y, Macdonell R et al. The Global Adherence Project (GAP): a multicenter observational study on adherence to diseasemodifying therapies in patients with relapsing-remitting multiple sclerosis. Eur J Neurol 2010; 18: 69-77.
4. Frid A, Hirsch L, Gaspar R et al. New injection recommendations for patients with diabetes. Diabetes Metab 2010; 36(Suppl 2): S3-18.
5. Nash P, Nayiager S, Genovese MC et al. Immunogenicity, safety, and efficacy of abatacept administered subcutaneously with or without background methotrexate in patients with rheumatoid arthritis: results from a phase III, international, multicenter, parallel-arm, open-label study. Arthritis Care Res (Hoboken) 2013; 65: 718-728.
6. Peyrot M, Rubin RR, Kruger DF, Travis LB. Correlates of insulin injection omission. Diabetes Care 2010; 33: 240-245.
7. Singer B, Bandari D, Cascione M et al. Comparative injection-site pain and tolerability of subcutaneous serum-free formulation of interferonbeta- 1a versus subcutaneous interferonbeta-1b: results of the randomized, multicenter, Phase IIIb REFORMS study. BMC Neurol 2012; 12: 154.
8. Aronson R. The role of comfort and discomfort in insulin therapy. Diabetes Technol Ther 2012; 14: 741-747.
9. Gazerani P, Wang K, Cairns BE, Svensson P, Arendt-Nielsen L. Effects of subcutaneous administration of glutamate on pain, sensitization and vasomotor responses in healthy men and women. Pain 2006; 124: 338-348.
10. Maurer M, Church MK. Inflammatory skin responses induced by icatibant injection are mast cell mediated and attenuated by H(1)-antihistamines. Exp Dermatol 2012; 21: 154-155.
11. Kivitz A, Cohen S, Dowd JE et al. Clinical assessment of pain, tolerability, and preference of an autoinjection pen versus a prefilled syringe for patient self-administration of the fully human, monoclonal antibody adalimumab: the TOUCH trial. Clin Ther 2006; 28: 1619-1629.
12. Krause RS, Moscati R, Filice M, Lerner EB, Hughes D. The effect of injection speed on the pain of lidocaine infiltration. Acad Emerg Med 1997; 4: 1032-1035.
13. Anderson G, Meyer D, Herrman CE et al. Tolerability and safety of novel half milliliter formulation of glatiramer acetate for subcutaneous injection: an open-label, multicenter, randomized comparative study. J Neurol 2010; 257: 1917-1923.
14. Chantelau E, Lee DM, Hemmann DM, Zipfel U, EchterhoffS. What makes insulin injections painful? BMJ 1991; 303: 26-27.
15. Jorgensen JT, Romsing J, Rasmussen M, Moller-Sonnergaard J, Vang L, Musaeus L. Pain assessment of subcutaneous injections. Ann Pharmacother 1996; 30: 729-732.
16. Van Metre TE Jr, Rosenberg GL, Vaswani SK, Ziegler SR, Adkinson NF. Pain and dermal reaction caused by injected glycerin in immunotherapy solutions. J Allergy Clin Immunol 1996; 97: 1033-1039.
17. Pourghaznein T, Azimi AV, Jafarabadi MA. The effect of injection duration and injection site on pain and bruising of subcutaneous injection of heparin. J Clin Nurs 2014; 23: 1105-1113.
18. Lim WH, Chan D, Boudville N et al. Patients' perceptions of subcutaneous delivery of darbepoetin alfa by autoinjector prefilled pen versus prefilled syringe: a randomized, crossover study. Clin Ther 2012; 34: 1948-1953.
19. Laursen T, Hansen B, Fisker S. Pain perception after subcutaneous injections of media containing different buffers. Basic Clin Pharmacol Toxicol 2006; 98: 218-221.
20. WMA. World Medical Association Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects. 52nd WMA General Assembly, Edinburgh, Scotland, October 2000. Last amended with: Note of Clarification on Paragraph 29 added by the WMA General Assembly, Washington 2002, Note of Clarification on Paragraph 30 added by the WMA General Assembly, Tokyo, Japan, 2004. The World Medical Association. 1964, revised 2004.
21. ICH Harmonised Tripartite Guideline. Guideline for Good Clinical Practice. 10 June 1996. Available from URL: http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Efficacy/E6_R1/Step4/E6_R1_Guideline.pdf. Accessed 24 April 2014.
22. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 1988; 54: 1063-1070.
23. Crawford JR, Henry JD. The positive and negative affect schedule (PANAS): construct validity, measurement properties and normative data in a large non-clinical sample. Br J Clin Psychol 2004; 43: 245-265.
24. Chan H. Effects of injection duration on site-pain intensity and bruising associated with subcutaneous heparin. J Adv Nurs 2001; 35: 882-892.
25. Scarfone RJ, Jasani M, Gracely EJ. Pain of local anesthetics: rate of administration and buffering. Ann Emerg Med 1998; 31: 36-40.
26. Parham SM, Pasieka JL. Effect of pH modification by bicarbonate on pain after subcutaneous lidocaine injection. Can J Surg 1996; 39: 31-35.
27. McKay M, Compion G, Lytzen L. A comparison of insulin injection needles on patients' perceptions of pain, handling, and acceptability: a randomized, open-label, crossover study in subjects with diabetes. Diabetes Technol Ther 2009; 11: 195-201.
28. Kamimura T, Miyamoto T, Yokota N et al. Higher incidence of injection site reactions after subcutaneous bortezomib administration on the thigh compared with the abdomen. Eur J Haematol 2013; 90: 157-161.
29. Williams G, Pickup J, Clark A, Bowcock S, Cooke E, Keen H. Changes in blood flow close to subcutaneous insulin injection sites in stable and brittle diabetics. Diabetes 1983; 32: 466-473.