Background: Recombinant human growth hormone (r-hGH) treatment can optimise growth potential; however, optimum outcomes are not always achieved owing to several reasons, including poor adherence. This analysis sought to operationalize psychosocial drivers of non-adherence in GH patients, using the three-component, evidence-based capability, opportunity and motivation behavioural framework (COM-b). The framework allows for matching of specific interventions to help modify behaviours, and the interaction between the components can help to explain why patients do not engage with a recommended behavioural change. This evidence-based approach may enhance patient-support programmes (PSPs) for people treated with Saizen who monitor their treatment with the easypod Connect platform.
Methods: A narrative review of the literature was conducted to determine drivers of non-adherence in people prescribed r-hGH treatment. Six overarching drivers were identified that could potentially be modified through behavioural intervention in both the patient and caregiver populations, as appropriate: disease and treatment coherence; emotional burden; treatment-related anxiety; self-administration; teenage years; and transition to adult/self-care. The drivers were then mapped across the disease and treatment journey to determine when support needs may fluctuate. These insights were used to guide recommendations to enhance the PSPs to provide content and techniques that will facilitate adherence and support overall disease management, delivered directly to patients and caregivers.
Support design recommendations: Three high-level support recommendations were made: 1) A personalisation questionnaire to identify individual needs and tailor support for each person. 2) Tailored reminder and support messaging delivered electronically, prioritised by behavioural topic (e.g. emotional burden). 3) PSP-nurse-coaching modules, focussed on core behavioural drivers and including evidence-based behaviour-change techniques.
Current stage of work: The personalisation questionnaire, tailored reminder and support messages, and nurse-coaching modules will be implemented within the Saizen PSP program. This program already includes other eHealth solutions, such as the growlink app, the easypod Connect platform and program-nurse support services.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology