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Non-Compliance with Growth Hormone Treatment in Children Is Common and Impairs Linear Growth

BACKGROUND: GH therapy requires daily injections over many years and compliance can be difficult to sustain. As growth hormone (GH) is expensive, non-compliance is likely to lead to suboptimal growth, at considerable cost. Thus, we aimed to assess the compliance rate of children and adolescents with...

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Autores principales: Cutfield, Wayne S., Derraik, José G. B., Gunn, Alistair J., Reid, Kyle, Delany, Theresa, Robinson, Elizabeth, Hofman, Paul L.
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031542/
https://www.ncbi.nlm.nih.gov/pubmed/21305004
http://dx.doi.org/10.1371/journal.pone.0016223
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author Cutfield, Wayne S.
Derraik, José G. B.
Gunn, Alistair J.
Reid, Kyle
Delany, Theresa
Robinson, Elizabeth
Hofman, Paul L.
author_facet Cutfield, Wayne S.
Derraik, José G. B.
Gunn, Alistair J.
Reid, Kyle
Delany, Theresa
Robinson, Elizabeth
Hofman, Paul L.
author_sort Cutfield, Wayne S.
collection PubMed
description BACKGROUND: GH therapy requires daily injections over many years and compliance can be difficult to sustain. As growth hormone (GH) is expensive, non-compliance is likely to lead to suboptimal growth, at considerable cost. Thus, we aimed to assess the compliance rate of children and adolescents with GH treatment in New Zealand. METHODS: This was a national survey of GH compliance, in which all children receiving government-funded GH for a four-month interval were included. Compliance was defined as ≥85% adherence (no more than one missed dose a week on average) to prescribed treatment. Compliance was determined based on two parameters: either the number of GH vials requested (GHreq) by the family or the number of empty GH vials returned (GHret). Data are presented as mean ± SEM. FINDINGS: 177 patients were receiving GH in the study period, aged 12.1±0.6 years. The rate of returned vials, but not number of vials requested, was positively associated with HVSDS (p<0.05), such that patients with good compliance had significantly greater linear growth over the study period (p<0.05). GHret was therefore used for subsequent analyses. 66% of patients were non-compliant, and this outcome was not affected by sex, age or clinical diagnosis. However, Maori ethnicity was associated with a lower rate of compliance. INTERPRETATION: An objective assessment of compliance such as returned vials is much more reliable than compliance based on parental or patient based information. Non-compliance with GH treatment is common, and associated with reduced linear growth. Non-compliance should be considered in all patients with apparently suboptimal response to GH treatment.
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spelling pubmed-30315422011-02-08 Non-Compliance with Growth Hormone Treatment in Children Is Common and Impairs Linear Growth Cutfield, Wayne S. Derraik, José G. B. Gunn, Alistair J. Reid, Kyle Delany, Theresa Robinson, Elizabeth Hofman, Paul L. PLoS One Research Article BACKGROUND: GH therapy requires daily injections over many years and compliance can be difficult to sustain. As growth hormone (GH) is expensive, non-compliance is likely to lead to suboptimal growth, at considerable cost. Thus, we aimed to assess the compliance rate of children and adolescents with GH treatment in New Zealand. METHODS: This was a national survey of GH compliance, in which all children receiving government-funded GH for a four-month interval were included. Compliance was defined as ≥85% adherence (no more than one missed dose a week on average) to prescribed treatment. Compliance was determined based on two parameters: either the number of GH vials requested (GHreq) by the family or the number of empty GH vials returned (GHret). Data are presented as mean ± SEM. FINDINGS: 177 patients were receiving GH in the study period, aged 12.1±0.6 years. The rate of returned vials, but not number of vials requested, was positively associated with HVSDS (p<0.05), such that patients with good compliance had significantly greater linear growth over the study period (p<0.05). GHret was therefore used for subsequent analyses. 66% of patients were non-compliant, and this outcome was not affected by sex, age or clinical diagnosis. However, Maori ethnicity was associated with a lower rate of compliance. INTERPRETATION: An objective assessment of compliance such as returned vials is much more reliable than compliance based on parental or patient based information. Non-compliance with GH treatment is common, and associated with reduced linear growth. Non-compliance should be considered in all patients with apparently suboptimal response to GH treatment. Public Library of Science 2011-01-31 /pmc/articles/PMC3031542/ /pubmed/21305004 http://dx.doi.org/10.1371/journal.pone.0016223 Text en Cutfield et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Cutfield, Wayne S.
Derraik, José G. B.
Gunn, Alistair J.
Reid, Kyle
Delany, Theresa
Robinson, Elizabeth
Hofman, Paul L.
Non-Compliance with Growth Hormone Treatment in Children Is Common and Impairs Linear Growth
title Non-Compliance with Growth Hormone Treatment in Children Is Common and Impairs Linear Growth
title_full Non-Compliance with Growth Hormone Treatment in Children Is Common and Impairs Linear Growth
title_fullStr Non-Compliance with Growth Hormone Treatment in Children Is Common and Impairs Linear Growth
title_full_unstemmed Non-Compliance with Growth Hormone Treatment in Children Is Common and Impairs Linear Growth
title_short Non-Compliance with Growth Hormone Treatment in Children Is Common and Impairs Linear Growth
title_sort non-compliance with growth hormone treatment in children is common and impairs linear growth
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031542/
https://www.ncbi.nlm.nih.gov/pubmed/21305004
http://dx.doi.org/10.1371/journal.pone.0016223
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