Adherence to Growth Hormone Therapy: A Practical Approach

Bozzola, Mauro; Pagani, Sara; Maffeis, Claudio; Bozzola, E.; Meazza, Cristina

doi:10.1159/000357975

Cited by 21 publications

(22 citation statements)

References 19 publications

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“…Our findings concur with the wider rhGH literature, [10, 15, 24-26, 28, 29, 30, 33, 34, 36-38]. Factors unique to the wider literature included: fear of side effects/long-term complications [15, 27, 35], the preference [36] and convenience of an injection device (ease of use, technical handling, and storage) [10, 24, 36], and accessibility of the rhGH distributing pharmacy [15] as well as sociodemographic factors (more specifically, the level of parental school education) [24, 29, 34, 38].…”

Section: Discussionsupporting

confidence: 93%

“…The full study selection process is illustrated in online supplementary Figure 1 (full reasons for exclusion are detailed in online suppl. Table 5 [10, 15, 24-30, 33-38]).…”

Section: Resultsmentioning

confidence: 99%

“…Studies that did not fulfil the criteria were omitted throughout the process, with accompanying reasons for exclusion (online suppl. Table 5 [10, 15, 24-30, 33-38]). A PRISMA flow chart outlining the full study selection process is presented in online supplementary Figure 1.…”

Section: Methodsmentioning

confidence: 99%

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Identifying Potentially Modifiable Factors Associated with Treatment Non-Adherence in Paediatric Growth Hormone Deficiency: A Systematic Review

Graham

Weinman

Auyeung³

2018

Horm Res Paediatr

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Background: Despite the developments of recombinant growth hormone (rhGH) treatment and the benefits in long-term clinical health outcomes, evidence has shown that many children with growth hormone deficiency (GHD) still fail to achieve their target adult height. Suboptimal outcomes have been largely attributed to treatment non-adherence. Methods: A search of 11 electronic databases was undertaken to identify relevant articles, published in English, between 1985 and 2018. Additional search strategies included hand-searching topic review articles to identify eligible studies. Articles were screened against the inclusion eligibility criteria and data on sample characteristics, study design, outcomes, and key findings was extracted. The results were narratively synthesised and categorised using the COM-B theoretical framework. Results: Twenty-one full-text articles were assessed for eligibility, of which 6 articles met the inclusion criteria. The prevalence of non-adherence in the included studies varied from 7 to 71%. Potentially modifiable factors associated with rhGH non-adherence were categorised within the COM-B framework; key factors included: a lack of knowledge and understanding of the condition and treatment, discomfort and pain associated with injections, and the quality of the healthcare professional-patient relationship. Conclusion: This review highlights the scope of the adherence problem evident amongst the paediatric GHD population and in addition presents the wide range of potentially modifiable factors that explain this health-related behaviour.

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Section: Discussionsupporting

confidence: 93%

“…The full study selection process is illustrated in online supplementary Figure 1 (full reasons for exclusion are detailed in online suppl. Table 5 [10, 15, 24-30, 33-38]).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Identifying Potentially Modifiable Factors Associated with Treatment Non-Adherence in Paediatric Growth Hormone Deficiency: A Systematic Review

Graham

Weinman

Auyeung³

2018

Horm Res Paediatr

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“…Bozzola et al suggested that regularly interviewing GHD patients could be a useful approach to improve adherence and also mentioned that communication with patients and their parents should be in a nonaggressive manner [66]. Muller et al conducted a randomized crossover study comparing a liquid formulation of GH with the older freeze-dried product and found that an overall preference was given to the liquid product, with 98% patients rating it as easier to use [67].…”

Section: Resultsmentioning

confidence: 99%

Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India

John¹,

Koledova

Kumar

et al. 2016

International Journal of Endocrinology

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In clinical practice, every year approximately 150,000 children are referred with short stature (SS) based on a cut-off of fifth percentile. The most important endocrine and treatable cause of SS is growth hormone deficiency (GHD). The lack of reliable data on the prevalence of GHD in India limits estimation of the magnitude of this problem. The diagnosis and treatment of GHD are hurdled with various challenges, restricting the availability of growth hormone (GH) therapy to only a very limited segment of the children in India. This review will firstly summarize the gaps and challenges in diagnosis and treatment of GHD based on literature analysis. Subsequently, it presents suggestions from the members at advisory board meetings to overcome these challenges. The advisory board suggested that early initiation of the therapy could better the chances of achieving final adult height within the normal range for the population. Education and awareness about growth disorders among parents, regular training for physicians, and more emphasis on using the Indian growth charts for growth monitoring would help improve the diagnosis and treatment of children with GHD. Availability of an easy-to-use therapy delivery system could also be beneficial in improving adherence and achieving satisfactory outcomes.

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“…Carefully constructed healthcare plans are the key and should include educational programmes, home support and regular reinforcement. Furthermore, it is mandatory to regularly interview patients with a non-aggressive approach to ensure effective communication with patients and their parents [89].…”

Section: Adherence To Gh Therapymentioning

confidence: 99%

Growth Hormone Deficiency: Diagnosis and Therapy in Children

Boiocchi¹,

Meazza²

2016

Restricted Growth - Clinical, Genetic and Molecular Aspects

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Short stature has been defined as a height below the 2 standard deviation for age, sex and ethnicity. Growth hormone deficiency (GHD) represents a condition characterized by reduced GH secretion, isolated or associated with other pituitary hormone deficiencies. In a child with short stature and growth deceleration, after the exclusion of other causes of growth failure, the diagnosis of GHD has to be confirmed by measurement of GH secretion after at least two stimulation tests. Patients with GHD should be treated with rhGH as soon as possible, to obtain normalization of growth and normal final height. The catch-up growth in response to rhGH therapy is maximal during the first years and could be affected by many variables, such as birth-weight, age and height at start of treatment and of puberty, and duration of treatment. Overall, rhGH is believed to be safe and significant side-effects in children are very rare, including benign intracranial hypertension, hyperglycaemia, arthralgia and myalgia. Patients with childhood onset GHD are usually retested in late adolescence to confirm the GHD persistence and to continue of GH therapy. In conclusion, the present chapter provides useful and updated information about the diagnosis, treatment and follow-up of children with GHD.

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Adherence to Growth Hormone Therapy: A Practical Approach

Cited by 21 publications

References 19 publications

Identifying Potentially Modifiable Factors Associated with Treatment Non-Adherence in Paediatric Growth Hormone Deficiency: A Systematic Review

Identifying Potentially Modifiable Factors Associated with Treatment Non-Adherence in Paediatric Growth Hormone Deficiency: A Systematic Review

Challenges in the Diagnosis and Management of Growth Hormone Deficiency in India

Growth Hormone Deficiency: Diagnosis and Therapy in Children

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