ESPE Abstracts

Background: For early identification of patients requiring adherence support, objective, real-time adherence data are needed. The easypod™ electromechanical injection device, in combination with the easypod™ connect ecosystem, electronically records and transmits, in real time, accurate records of the date, time and dose injected for patients receiving recombinant human growth hormone (r-hGH) to treat growth disorders. Healthcare professionals can use data extracted from easypod™ connect to monitor patient adherence and growth outcomes, which, in recent years, has been augmented by digital health solutions.

Aim: To evaluate adherence rates over time and growth outcomes by level of adherence using data from the easypod™ connect ecosystem.

Patients and Methods: Adherence and height data from 2007 to the end of 2020 were extracted from easypod™ connect. Height data for patients aged ≤18 years with ≥2 recorded growth measurements during treatment were included. Regional adherence rates were evaluated annually between 2010 and 2020. Linear interpolation between height measurements was applied to calculate monthly Height Standard Deviation Scores (HSDS). Adherence overall and between height measurements were categorised as high (≥85% of prescribed doses administered), intermediate (>56 to <85%) and low (≤56%). Multi-level linear regression techniques were applied to study the effect of adherence level on ∆HSDS.

Results: Adherence data were available for 20,264 patients from 38 countries who transmitted data from 11,494,170 injections to the ecosystem. In total, 2,215 patients with 12,943 height measurements were analysed. The proportion of high adherence increased over time in European (76% in 2010; 82-84% in 2015-2019; 86% in 2020), North-American (Canadian) (65% in 2010; 68% in 2015; 88% in 2019-2020) and Asian (58-62% in 2014-2015 [insufficient data before 2014]; 68-73% in 2016-2020) patients. No consistent change in adherence was found among Latin-American and Caribbean patients. Adherence level had a statistically significant effect on ∆HSDS (P < 0.001). Mean ∆HSDS were 0.4, 0.7, 1.0 and 1.1 after 12, 24, 36 and 48 months’ treatment, respectively, in patients with high monthly adherence, 0.3, 0.6, 0.8 and 0.9 in patients with intermediate monthly adherence and 0.2, 0.5, 0.6 and 0.7 in patients with low monthly adherence.

Conclusion: Data extracted from easypod™ connect showed high adherence rates and, for most regions, a positive trend in adherence to r-hGH therapy over time. A higher level of adherence resulted in a higher rate of catch-up growth, and its cumulative effect increased over time. The easypod™ connected injection device has the potential to optimise adherence and growth outcomes.