GH TREATMENT ADHERENCE IN CHILDHOOD AND ADOLESCENCE IMPROVES USING EASYPODTM DEVICE: DATA DEMONSTRATION IN AN ITALIAN CENTRE

Abstract

Objectives: Poor adherence to GH treatment is one of the pitfalls affecting the treatment efficacy. This study evaluates the GH treatment, using easypodTM in young patients over 6 months of therapy and describes the relationship between treatment efficacy and adherence. Methods: We collected the retrospective data registered in the electronic device easypodTM in 40 patients treated with GH. Number and doses of injection were used to calculate the percentage of treatment adherence. The inclusion criteria were: GH deficiency and the existence of one of the clinical condition in which GH is available: GHD, SGA, chronic renal failure, Turner syndrome. The GH efficacy was evaluated using the height gain in SD. Results: adherence was 92.20%, inversely related to patients’ age (p=0.023), significantly higher in patients with age 10-13 y. Adherence was inversely related to the y of therapy (p=0.003) and to the number of GH doses/week (p=0.012). Treatment efficacy did not correlate with adherence. Adherence showed a statistically significant correlation with IGF-1 (p=0.032). 35% referred discomfort at site of injection, 5% referred pain. The adherence was significantly lower in patients who self-injected GH (80.91%), compared to those treated by parents (95.2%) (p=0.002). 37.5% used all sites of injection, 32.5% refused 1 site, 12.5% 2, 17.5% used 1 site. The number of refused sites was inversely related to the adherence (p=0.011). The parents’ “level of education” did not show a statistically significant correlation with the adherence and data registered by the electronic device demonstrate that 35% of patients erroneously report their treatment adherence. Conclusions: Childhood and adolescent patients with GH deficiency show a high adherence to GH treatment monitored by easypodTM. Treatment adherence is inversely related to patients’ age, confirming the difficulties to treat chronic diseases especially in adolescence. The study suggests the importance of an electronic device able to measure adherence and easypodTM represents one of the most recent advances obtained in this field. This electronic device could represent a system to monitor patients’ adherence in chronic treatments, especially if they are expensive and self-managed by the family.