Adherence to growth hormone therapy: a practical approach

Horm Res Paediatr. 2014;81(5):331-5. doi: 10.1159/000357975. Epub 2014 Apr 3.

Abstract

Background: Early detection of suspected poor adherence to growth hormone (GH) therapy is crucial to achieve normal final height in GH-deficient (GHD) patients.

Patients: 106 children (73 M, 33 F) with a median age of 10.47±3.48 years (mean±standard deviation score (SDS)) exhibited short stature (-1.76±0.64 SDS) and a delayed bone age (8.68±3.42 years). Severe GHD was found in 28, while partial GHD was seen in 78 cases, with low IGF-I values. Recombinant human GH was administered by daily subcutaneous injection at a dosage of 21 µg/kg in prepubertal and 25 µg/kg in pubertal patients.

Results: Poor adherence was suspected in a number of patients, but clearly demonstrated in only 4 cases with persistent reduced height velocity in spite of a corrected therapeutic regimen. These patients admitted incomplete adherence to GH injections and clinical and anthropometric measurements revealed their poor response to therapy.

Conclusions: To efficaciously improve adherence in GHD patients, it is mandatory to regularly interview patients; a non-aggressive approach might be utilized to ensure effective communication with patients and their parents.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Growth Disorders / drug therapy*
  • Growth Disorders / physiopathology
  • Growth Disorders / psychology
  • Human Growth Hormone / administration & dosage*
  • Humans
  • Injections, Subcutaneous
  • Male
  • Medication Adherence*

Substances

  • Human Growth Hormone