Adherence to Growth Hormone Therapy: Results of a Multicenter Study |
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| Affiliation: | 1. Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey;2. Pediatric Endocrinology Clinic, Dr. Sami Ulus Obstetrics and Gynecology, Children’s Health and Disease Training and Research Hospital;3. Department of Pediatric Endocrinology, Ankara Children’s Hematology and Oncology Training and Research Hospital, Ankara, Turkey;4. Department of Pediatrics, Pediatric Endocrinology Unit, Ankara University, Faculty of Medicine, Ankara, Turkey;5. Endomer Pediatric Endocrinology Center, Ankara, Turkey;6. Department of Pediatric Endocrinology and Metabolism, Ege University, Faculty of Medicine, Izmir, Turkey;7. Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul University, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey;8. Department of Pediatrics, Pediatric Endocrinology Unit, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey.;1. Department of Medicine, University of California San Francisco, San Francisco, California;2. Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom;3. Department of Laboratory Medicine, University of California San Francisco, San Franciscoe, California.;1. Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel;2. Sackler School of Medicine, Tel-Aviv University, Israel;3. Women and Children’s Health Research Unit, Gertner Institute.;1. Sanofi U.S., Inc, Bridgewater, NewJersey;2. PRO Unlimited, Boca Raton, Florida;3. STATinMED Research, Inc, Ann Arbor, Michigan;4. University of Michigan, Ann Arbor, Michigan. |
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| Abstract: | ObjectiveTo evaluate the adherence to growth hormone (GH) therapy and identify the influencing factors and outcomes in children.MethodsA total of 217 GH-naïve patients in 6 pediatric endocrinology clinics were enrolled in the study. Structured questionnaires were filled out and patients were evaluated at the initiation and 3rd, 6th, and 12th months of therapy. Patients were categorized into 4 adherence segments based on percentage of doses omitted at each evaluation period, classified as excellent if 0%, good if 5%, fair if 5 to 10%, and poor if > 10%.Results:There was a decrement in adherence to GH therapy during the study period (P = .006). Patients who showed excellent and good adherence to therapy had better growth velocity and growth velocity standard deviation scores (SDSs) (P = .014 and P = .015, respectively). A negative correlation between growth velocity SDS and number of missed injections was also observed (r = − .412; P = .007). A positive correlation between delta insulin-like growth factor-1 (IGF-1) SDS and growth velocity was demonstrated (r = .239; P = .042). IGF-1 levels were significantly higher in patients who showed excellent and good adherence to therapy (P = .01). Adherence was better in boys than in girls (P = .035), but adherence rates were not associated with age, cause of GH treatment, socioeconomic status, person who administered the injections, type of injection device, or GH product.ConclusionPoor adherence to GH therapy was common in our group of patients and was one of the factors underlying suboptimal growth during therapy. Before considering other problems that can affect growth, clinicians should confirm good adherence to therapy. (Endocr Pract. 2014;20:46-51) |
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