ESPE2022 Poster Category 1 GH and IGFs (27 abstracts)
1Uludag University, Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey; 2University of Health Sciences Turkey, Ankara Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey; 3İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey; 4Ege University Faculty of Medicine, Department of Pediatric Endocrinology, Izmir, Turkey; 5stanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey; 6Ondokuz Mayis University Faculty of Medicine, Department of Endocrinology, Samsun, Turkey; 7Duzce University Faculty of Medicine, Department of Endocrinology, Duzce, Turkey; 8Kocaeli University Faculty of Medicine, Department of Endocrinology, Kocaeli, Turkey; 9Necmettin Erbakan University, Meram Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey; 10Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey; 11Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, Izmir, Turkey; 12Ataturk University Faculty of Medicine, Department of Pediatric Endocrinology, Erzurum, Turkey; 13Inonu University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey
Introduction: Treatment adherence is crucial for the success of Growth Hormone (GH) therapy. Non-adherence rates have varied over a wide range from 5% to 80% in the literature. Several factors may have an impact on treatment adherence. Besides, with the COVID-19 pandemic that affected the whole world, there were problems with the hospital admission and routine controls of the patients who used GH treatment.
Objective: The survey's primary objective is to investigate adherence to treatment in patients with GH. The survey will also investigate potential problems in GH treatment during the pandemic.
Materials and Methods: The survey was sent to pediatric endocrinologists. Patient data, diagnosis, history of pituitary surgery, current GH doses, duration of GH therapy, who administers the therapy (mother and father, patient), duration of missed doses, reasons for missed doses as well as problems associated with GH therapy, and missed dose data in the recent year (after the onset of the pandemic) and causes were asked. The treatment adherence category was determined based on missed dose rates over the past month (0 to 5%, full adherence; 5.1 to 10% moderate adherence; >10% non-adherence).
Results: 427 cases from thirteen centers were evaluated. The median age of diagnosis of the cases (56.2% male) was 8.5 (0.13-16) years. GH treatment indications were isolated GH deficiency (61.4%), multiple pituitary hormone deficiency (14%), Turner syndrome (7.5%), idiopathic GH deficiency (7.5%), and SGA (2.8%), and other (6.8%). GH therapy was administered by 70% parents and 30% patients. Mean daily dose was 32.3 mg/kg, the annual growth rate was 7.52±2.7 cm. GH adherence rate was good (70.3%), moderate (14.7%), and poor (15%), respectively. The reasons for non-adherence were mainly due to forgetting, being tired, inability to access medication, and pen problems. It was noteworthy that the COVID-19 pandemic had a negative effect on adherence in 22%. The problem with an appointment, taking the medication, and anxiety about going to the hospital were the main reasons. There was no difference between genders in the adherence rate. Non-adherence to GH treatment decreased statistically when the patient administered the treatment, increased age, the duration of the treatment, and COVID-19 pandemia. A non-statistical decrease was found in the annual growth rate as the skip rate increased.
Conclusion: During the COVID-19 pandemic, poor adherence was found to be 15%, and the duration of hormone use and advanced age are important factors. The pandemic period negatively affected compliance.