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National audit of patient choice in pediatric GH therapy
Shirley Langham1, Jeremy Kirk,
1Department of Endocrinology, Hospital for Sick Children, Great Ormond Street, London, UK.
Insights
Most UK pediatric endocrinology units offer patient choice for growth hormone (GH) therapy. This involves device demonstrations and instructional materials, with larger centers providing more options.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Patient Choice
Background:
- Assessing patient autonomy in pediatric growth hormone (GH) therapy initiation.
- Focus on practices within the UK and Republic of Ireland.
Purpose of the Study:
- To evaluate the extent and methods of free patient choice offered.
- To understand the process of selecting GH devices for pediatric patients.
Main Methods:
- Semistructured questionnaire distributed to members of the British Society for Paediatric Endocrinology and Diabetes.
- Analysis of responses from 55 pediatric endocrinology units.
Main Results:
- 89% of 52 responding units offer patient choice for GH therapy.
- Methods include device demonstration, instructional DVDs, or a combination.
- Larger centers with more manufacturers/devices correlate with more new GH patients.
Conclusions:
- The majority of centers provide patient choice in GH therapy selection.
- Diverse methods are employed, with variations based on center size and resources.
- Patient choice is becoming standard practice in pediatric GH initiation.
Background:
To assess free patient choice for pediatric patients commencing growth hormone (GH) therapy within the UK and Republic of Ireland.
Methods:
A semistructured questionnaire was sent to all members of the British Society for Paediatric Endocrinology and Diabetes.
Results:
Of 55 units responding, three do not commence patients on GH. The remaining 52 units included 21 from (all) historic growth centres, 13 from other tertiary centres, and 18 from district general hospitals. 46/52 units (89%) offer free patient choice, involving: demonstration of devices (n = 15), instructional DVDs (6), a combination of both (20), or other (3). Median (range) time spent choosing the GH device was 60 (25-150) min. Device demonstration involved: dialling up doses (39 units), assembling/dissembling (38), GH reconstitution (33), considering facilities provided by manufacturer (25), injecting patient (19), injecting parent (17), showing additional material (11), and cost consideration (4). Median (range) number of steps shown per unit was 5 (1-8), with correlation between numbers of manufacturers/devices and new patients commenced on GH per unit (R = 0.62 and 0.61, both p < 0.01), but not with time spent showing devices (R = 0.12 and 0.22, p > 0.05).
Conclusion:
Most units now offer some form of patient choice for new patients commencing GH therapy, although this involves several different methods, with larger units offering more manufacturers and more devices.
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