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Review
. 2022 Jul 11:16:1663-1671.
doi: 10.2147/PPA.S271453. eCollection 2022.

Adherence to r-hGH Therapy in Pediatric Growth Hormone Deficiency: Current Perspectives on How Patient-Generated Data Will Transform r-hGH Treatment Towards Integrated Care

Martin O Savage  1 , Luis Fernandez-Luque  2 , Selina Graham  3 , Paula van Dommelen  4 , Matheus Araujo  5 , Antonio de Arriba  6 , Ekaterina Koledova  7
Affiliations
Review

Adherence to r-hGH Therapy in Pediatric Growth Hormone Deficiency: Current Perspectives on How Patient-Generated Data Will Transform r-hGH Treatment Towards Integrated Care

Martin O Savage et al. Patient Prefer Adherence. .

Abstract

Pediatric growth hormone (GH) deficiency is a licensed indication for replacement therapy with recombinant human growth hormone (r-hGH). Treatment, consisting of daily subcutaneous injections, extends from the time of diagnosis until cessation of linear growth at completion of puberty. Suboptimal adherence to r-hGH therapy is common and has been well documented to substantially impair the growth response and achievement of the optimal goal which is attainment of adult height within the genetic target range. The causes of poor adherence are complex and include disease-, patient-, doctor-, and treatment-related factors. Interventions for suboptimal adherence are important for a long-term successful outcome and can include both face-to-face and digital strategies. Face-to-face interventions include behavioral change approaches such as motivational interviewing and non-judgmental assessment. Medical and nursing staff require training in these techniques. Digital solutions are rapidly advancing as evidenced by the electronic digital auto-injector device, easypod® (Merck Healthcare KGaA, Darmstadt, Germany), which uses the web-based easypod® connect platform allowing adherence data to be transmitted electronically to healthcare professionals (HCPs), who can then access GH treatment history, enhancing clinical decisions. Over the past 10 years, the multi-national Easypod® Connect Observational Study has reported high levels of adherence (>85%) from up to 40 countries. The easypod® connect system can be supported by a smartphone app, growlink™, which facilitates the interactions between the patients, their care team, and patient support services. HCPs are empowered by new digital techniques, however, the human-digital partnership remains essential for optimal growth management. The pediatric patient on r-hGH therapy will benefit from these innovations to enhance adherence and optimize long-term response.

Keywords: behavioral support; data; digital; growth; participatory medicine.

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Conflict of interest statement

MOS has consultancy agreements with Merck Healthcare KGaA Darmstadt and Pfizer as well as honoraria for lectures from Ipsen, GeneSciences, and Sandoz. LF-L is Chief Scientific Officer at Adhera Health Inc., Palo Alto, CA, USA. SG and PvD have consultancy agreements with Merck. MA has previously had a consultancy agreement with Merck. AdA does not have any conflicts of interest to declare. EK is an employee of Merck Healthcare KGaA, Darmstadt, Germany and holds shares in the company. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Continuous feedback loop based on patient-generated data. The data provided by patients, the HCP team and data scientists contribute to the development of an enhanced ecosystem.
See this image and copyright information in PMC

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