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Identifying Potentially Modifiable Factors Associated with Treatment Non-Adherence in Paediatric Growth Hormone

Selina Graham1, John Weinman2, Vivian Auyeung2

  • 1Institute of Pharmaceutical Science, King's College London, London, United Kingdom, selina.graham@kcl.ac.uk.

Hormone Research in Paediatrics
|December 7, 2018
PubMed

Insights

Many children with growth hormone deficiency (GHD) do not achieve their target height due to non-adherence to recombinant human growth hormone (rhGH) treatment. Key adherence barriers include lack of knowledge, injection discomfort, and poor patient-provider relationships.

Area of Science:

  • Pediatric Endocrinology
  • Pharmacological Adherence Research

Background:

  • Recombinant human growth hormone (rhGH) treatment improves outcomes for children with growth hormone deficiency (GHD).
  • However, many GHD patients do not reach their target adult height, often due to suboptimal treatment adherence.

Purpose of the Study:

  • To review and synthesize evidence on non-adherence to rhGH treatment in pediatric GHD.
  • To identify modifiable factors contributing to treatment non-adherence using the COM-B framework.

Main Methods:

  • Systematic literature search of 11 electronic databases (1985-2018) and hand-searching of review articles.
  • Screening of articles against inclusion criteria and extraction of relevant data.
  • Narrative synthesis and categorization of findings using the COM-B theoretical framework.

Main Results:

  • Six studies met the inclusion criteria, revealing rhGH non-adherence rates ranging from 7% to 71%.
  • Identified modifiable factors influencing adherence included: lack of patient/parental knowledge, injection-related pain/discomfort, and the healthcare professional-patient relationship quality.

Conclusions:

  • Significant adherence challenges exist within the pediatric GHD population undergoing rhGH therapy.
  • Addressing modifiable factors like education, injection experience, and patient-provider communication is crucial for improving adherence and clinical outcomes.
Abstract

Keywords:
AdherenceGrowth hormone deficiencyRecombinant human growth hormone treatmentSystematic review

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