ESPE Abstracts

Context: The outcome of a treatment depends largely on the observance and compliance of the patient. Studies analyzing therapeutic compliance in chronic endocrine diseases are rare and especially controversial in childhood. Studies have reported poor adherence in 6-50% of cases.

Patients and Methods: We studied treatment compliance in 100 children treated with subcutaneous growth hormone for growth hormone deficiency, intrauterine growth retardation (IUGR), Turner syndrome and idiopathic short stature, followed for at least one year in pediatric endocrinology consultation at the Central Hospital of Army in Algiers. This compliance was assessed by a quiz. The number of missed injections, change of injection site, injection technique, presence or absence of pain and storage conditions were investigated.

Results: Questionnaires were completed in 100 children (52 boys and 48 girls). The average age was 10.98 ± 3.98 years at the evaluation, and 7.26 ± 3.71 years at diagnosis. The mean duration of treatment was 3.26 ± 2.04 years. The treatment was stored in the refrigerator in 97% of cases. The mother in 46% of cases performed the injection. It was done in 46% of cases in the arms, and the injection site was changed in 95% of cases. Twenty-eight of the children declared that the injection was painful, and this pain was evaluated at 4/10 on average. The number of missed injections was 0.12 times per week, 0.56 times per month and 6.83 times per year. Thirteen % of children admitted that they made a mistake in the dose of treatment, especially when switching from the old pen to the new one. Children maintain the injection for 10 seconds in 89% of cases.

Conclusion: This study demonstrated a good therapeutic compliance of children and their parents, probably in relation to the benefit of the treatment which improved height. Growth hormone treatment is generally well accepted and not very demanding.