ESPE2023 Poster Category 1 GH and IGFs (48 abstracts)
Assessment of the rhGH treatment compliance in children with growth hormone deficiency.
Dorian Scheuring 1 , Mieczysław Walczak 1 , Katarzyna Nowak 1 , Wojciech Dragan 2 , Jerzy Starzyk 3 , Anna Wędrychowicz 3 , Alicja Kapusta 3 , Artur Bossowski 4 , Beata Sawicka 4 , Aneta Gawlik 5 , Ewa Błaszczyk 5 , Joanna Gieburowska 5 , Iwona Beń-Skowronek 6 , Aleksandra Trwoga 6 , Martyna Sokół 6 , Maria Kołtowska-Häggström 7 , Marzena Kolasa-Kicińska 8 , Anna Łupińska 8,9 , Renata Stawerska 8,9 , Andrzej Lewiński 8,10 , Adam Dudek 11 , Artur Mazur 11 , Agnieszka Zachurzok 12 , Magdalena Mierzwa 12 , Beata Wikiera 13 , Beata Pyrżak 14 , Ewelina Witkowska-Sędek 14 , Ewa Witkowska-Krawczak 14 , Bogumiła Szewczak-Matan 14 , Andrzej Kędzia 15 , Elżbieta Moszczyńska 16 , Karolina Kot 16 , Dorota Birkholz-Walerzak 17 , Małgorzata Myśliwiec 17 & Elżbieta Petriczko 1
1Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland. 2Institute of Psychology, Jagiellonian University, Cracow, Poland. 3Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland. 4Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Białystok, Białystok, Poland. 5Department of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland. 6Department of Paediatric Endocrinology and Diabetology, Medical University of Lublin, Lublin, Poland. 7Proper Medical Writing, Warsaw, Poland. 8Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland. 9Department of Paediatric Endocrinology, Medical University of Lodz, Lodz, Poland. 10Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland. 11Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland. 12Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland. 13Department of Pediatric Endocrinology and Diabetology Wroclaw Medical University, Wrocław, Poland. 14Department of Paediatrics and Endocrinology, Medical University of Warsaw, Warsaw, Poland. 15Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznań, Poland. 16Department of Endocrinology and Diabetology Children's Memorial Health Institute, Warsaw, Poland. 17Department of Paediatrics, Diabetology and Endocrinology, University Clinical Centre in Gdańsk, Gdańsk, Poland
Aim: To identify factors affecting compliance to treatment with recombinant growth hormone (rhGH) in children with growth hormone deficiency (GHD).
Study population and Methods: The following data were collected during standard visits in 8 endocrine clinics in Poland: medical history, auxological measurements, laboratory tests and the numbers of empty and full rhGH ampoules dispensed and returned by the patients. The observation covered 6 months of treatment. The study group consisted of 319 children aged (years) 1.4-17.7 (M=12.06; SD=3.27), including 109 girls. To examine the impact of a child’s personal and familial characteristics on compliance, two generalized linear mixed models were run using the mixed procedure in SPSS 28 (SPSS Inc., 2021) – the first with compliance treated as a linear variable (% of compliance), and the second with compliance treated as an ordinal variable. Both models included a random effect of the data collection site and a fixed effect of the child’s age, sex, level of parental education, duration of treatment, mid parental height (MPH), pubertal stage, and rhGH self-administration. Compliance was categorised as: good - one dose per week missed (>86% of doses administered), moderate – one to two doses missed per week (57-86%) and poor – three and more doses per week missed (<57%).
Results: Good compliance was observed in 85,9% of patients (in 84,4% of girls and in 86,7% in boys), moderate in 13,2% and poor in 0,9%. The highest proportion of patients with good compliance was detected in children between 8 and 14 years (91,2%) and the lowest in those above 14 years (76,2%).) More than 80% of patients with normal serum concentration of insulin-like growth factor 1 (IGF-1) presented good compliance. Mixed model analysis revealed the main effect of the pubertal stage - in the first model (F(2,261)=3.829, P=0.023), indicating that children with more advanced puberty complied with rhGH treatment worse than children with lower puberty stages (Beta= -6.6 (95%CI - 12.25; -0.95) P=0.022. In the second model, the main effect was paternal education (F(2,260)=2.964, P=0.05) indicating that children of fathers with low education had worse compliance (Beta= -1.07(95%CI -2.15, 0) P=0.05.
Conclusion: We found good compliance to rhGH routine treatment in children with GHD. Our results indicate that lower father education and patient’s more advanced puberty stage adversely affect compliance.
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