ESPE Abstracts

Background: Optimising adherence to treatment in paediatric patients is important, since non-adherence may lead to incorrect interpretation of growth results and in the treatment course. It has been found that injection frequency is correlated with growth response and final height among children treated with rhGH.

Objective and hypotheses: The main aim of this study was to evaluate IGF1 levels and growth velocity before and after a medical intervention in non-adherent patients group of our service.

Method: This was an observational, longitudinal study. We used the issued-uncharged rhGH presctiptions of the last 6 months to evaluate compliance. Medium-low adherence was defined as a rate below 92%. 33 patients were included. We contacted their families in order to inform them about the importance of the treatment, exposing the reasons for poor adherence. Twice monthly monitoring was carried out during 6 month. Furthermore, patients were asked to bring their empty vials in each visit. Growth velocity and IGF1 values were calculated before the intervention and were re-calculated afterwards, expressed in S.D.s.

Results: The initial adherence rate was 80.8%. No differences were found in relation to GH deficiency diagnosis, age, gender or duration of treatment. After intervention the adherence rate was 91.7% (P<0.001). Mean S.D.s IGF1 before intervention was 1.44 (±0.75) vs 1.70 (±0.86) 6 months after intervention (P: 0.031). Similar results occur with mean S.D.s growth velocity −0.20 (±1.3) vs 0.66 (±1.48) before and after intervention respectively (P: 0.02). A positive relationship was observed between changes in S.D.s IGF1 (Final S.D.s IGF1 minus initial S.D.s IGF1) and changes in adherence to treatment, however the correlation coefficient did not reach formal statistical significance (r=0.355; P=0.059).

Conclusion: Adherence to rhGH treatment is efficaciously improved by an educational intervention that involves patients and their families, and this improvement has visible and relevant consequences on clinical and biochemical outcomes in a relative short period of time.