Understanding the Growth Hormone Therapy Adherence Paradigm: A Systematic Review

被引：127

作者：

Fisher, Benjamin G. ^{[1
]}

Acerini, Carlo L. ^{[1
,2
]}

机构：

[1] Univ Cambridge, Dept Paediat, Cambridge CB2 0QQ, England

[2] Cambridge Univ Hosp Fdn NHS Trust, Weston Ctr, Inst Metab Sci, Cambridge CB2 0QQ, England

来源：

HORMONE RESEARCH IN PAEDIATRICS | 2013年 / 79卷 / 04期

关键词：

Growth hormone therapy; Serum insulin-like growth factor I; Patient compliance; GH-DEFICIENT ADULTS; QUALITY-OF-LIFE; I IGF-I; PATIENT ADHERENCE; CROSSOVER TRIAL; TURNER-SYNDROME; RENAL-FAILURE; SHORT-STATURE; CHILDREN; INJECTION;

D O I：

10.1159/000350251

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Growth hormone (GH) therapy is used to treat a variety of growth disorders in childhood/adolescence. Its efficacy is thought to be dependent on patients' adherence to their treatment regimen. Methods: PubMed was searched using the keywords 'growth hormone', 'child'[Mesh], 'adolescent'[Mesh], and 'patient compliance'[Mesh]. Results: Most studies of adherence to paediatric GH therapy have used either issued/encashed GH prescriptions or questionnaires. Estimates of prevalence of non-adherence vary from 5-82%, depending on the methods and definitions used. Different studies have variously demonstrated an association (or lack thereof) between adherence and age, socioeconomic status, treatment duration, injection device used and injection-giver. A number of interventions have been proposed to improve adherence, including offering a choice of injection device, but none are supported by trials. Poor adherence is associated with reduced height velocity and likely increased economic costs; evidence for other effects is circumstantial. Conclusion: Adherence to paediatric GH therapy is suboptimal, which may partially explain why the mean final height attained is below that of the general population. Analysis of the causes of non-adherence is complicated by conflicting evidence from different studies. Multifactorial interventions are most likely to be successful in improving adherence. We make recommendations for further research. Copyright (C) 2013 S. Karger AG, Basel

引用

页码：189 / 196

页数：8

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