Managing Paediatric Growth Disorders: Integrating Technology Into a Personalised Approach

Abstract

Long-term growth management can be challenging for patients, families and healthcare professionals (HCP). Personalised optimal responses to growth hormone (GH) therapy depend on the creation of a good working relationship between the patient and family and the HCPs responsible for care. Current unmet needs in growth management will be discussed, focusing on the likelihood of a poor growth response and its identification and management with emphasis on the importance of good adherence to GH therapy. Digital tools are now available to record injections and communicate accurate adherence data to the HCP and patient. Psychological barriers to good adherence will be covered with techniques identified to change behaviour to improve outcome. Motivational interviewing is a valuable skill, which needs teaching to both medical and nursing HCPs for enhanced quality of the relationship with the patient and family. Key messages are first the importance of personalised care with the HCP using acquired psychological skills to prevent and manage poor adherence. Secondly, the human-eHealth partnership is necessary to maximise the benefit of new digital tools involved in successful growth management.

Digital Health for Supporting Precision Medicine in Pediatric Endocrine Disorders: Opportunities for Improved Patient Care

“…Thus, adherence strategies need to be focused and personalized, with behavioral aspects linked with clinical outcomes ( 88 ). Questions remain regarding what digital health tools are needed by clinicians and patients; they should be part of integrated care, with all stakeholders involved in design ( 89 ). This is important to ensure the utility and usability of the systems, and also to ensure the safety and confidentiality of digital health information and electronic health records.…”

The Changing Face of Paediatric Human Growth Hormone Therapy

“…Trained medical and nursing personnel are required to sensitively question the child and family. There are multiple potential reasons for poor adherence which can be seen in the context of the behavioural COM-B model [45,46].…”

Growth Hormone Therapy for Paediatric Growth Disorders: The Past, Present, and Future

“…Effective management of poor adherence to hGH requires the paediatric endocrinologist or specialist nurse to learn techniques of nonjudgmental motivational interviewing [52]. Organization, time, knowledge of common issues affecting adherence, and the ability to build a close relationship with the family with open questions and emphasis on pre-hGH treatment education are key components of this type of HCP-patient interaction.…”