ESPE2024 Poster Category 1 Growth and Syndromes 2 (10 abstracts)
Compliance in children with growth hormone deficiency treated with recombinant growth hormone (rhGH): a multicentre study in Poland.
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 8,9 , Adam Dudek 10 , Artur Mazur 10 , Agnieszka Zachurzok 11 , Magdalena Mierzwa 11 , Beata Wikiera 12 , Beata Pyrżak 13 , Ewelina Witkowska-Sędek 13 , Ewa Witkowska-Krawczak 13 , Bogumiła Szewczak-Matan 13 , Andrzej Kędzia 14 , Elżbieta Moszczyńska 15 , Karolina Kot 15 , Dorota Birkholz-Walerzak 16 , Małgorzata Myśliwiec 16 , Maria Żbikowska-Bojko 17 , Katarzyna Szafarska 17 , Olgierd Pilecki 17 & Elżbieta Petriczko 1
1Department of Paediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland. 2Institute of Psychology, Jagiellonian University, Cracow, Poland. 3Department of Paediatric and Adolescent Endocrinology, Paediatric Institute, Jagiellonian University Medical College, Cracow, Poland. 4Department of Paediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Białystok, Białystok, Poland. 5Department of Paediatrics and Paediatric 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, Łódź, Poland. 9Department of Paediatric Endocrinology, Medical University of Lodz, Łódź, Poland. 10Department of Paediatrics, Paediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland. 11Department of Paediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland. 12Department and Clinic of Paediatrics, Endocrinology, Diabetology and Metabolic Diseases Wroclaw Medical University, Wrocław, Poland. 13Department of Paediatrics and Endocrinology, Medical University of Warsaw, Warsaw, Poland. 14Department of Paediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznań, Poland. 15Department of Endocrinology and Diabetology Children's Memorial Health Institute, Warsaw, Poland. 16Department of Paediatrics, Diabetology and Endocrinology, University Clinical Centre in Gdańsk, Gdańsk, Poland. 17Department of Paediatrics, Endocrinology and Diabetology, Provincial Children"s Hospital, Bydgoszcz, Poland
Objective: The aim of this study was to assess the compliance with recombinant growth hormone (rhGH) therapy in children diagnosed with growth hormone deficiency (GHD) and identify the factors that may influence compliance.
Study Population and Methods: This multicentre study was conducted in 12 endocrine clinics in Poland. During routine visits, medical history, auxological measurements, laboratory tests, and the quantity of full and empty rhGH vials prescribed and returned by the patients were collected. The observation period spanned six months. The study group comprised 480 children (169 girls) aged 3.4-17.8 years (mean age: 12.15; standard deviation: 3.08). To examine the relationships between child’s personal and familial characteristics and compliance, we used a chi-square test or Fisher exact test. All calculations were performed with the use of SPSS 28. Compliance was categorized as: good (less than one dose missed per week, >86% of doses administered), moderate (one to two doses missed per week, 57-86% compliance), and poor (three or more doses missed per week, <57% compliance).
Results: The findings revealed that 85.9% of patients (88.2% of girls and 86.2% of boys) demonstrated good compliance with rhGH treatment. Moderate compliance was observed in 11.4% of patients, while 2.7% exhibited poor compliance. Among the different age groups, children between 8 and 14 years had the highest percentage of patients with good compliance (90%), whereas those below the age of 8 had the lowest percentage (82.5%). No statistical significance was found between compliance in individual groups. A positive correlation was observed between good compliance and the presence of comorbidities that did not affect growth, with 91.6% of these patients demonstrating good compliance (P = 0.06). Conversely, the lowest percentage of patients with good compliance was found among those in an advanced stage of puberty (77.6%, P = 0.022). Regarding parental education level, the highest compliance rate was observed among children whose fathers reported secondary education (89.5% with good compliance, P = 0.006).
Conclusion: The majority of patients included in this study demonstrated good compliance with rhGH treatment for GHD. Notably, a positive correlation was observed between good compliance and the average level of fathers' education and the presence of comorbidities that do not affect growth. Conversely, there was a negative correlation between compliance and advanced puberty. These findings emphasize the significance of considering personal and familial factors when evaluating compliance in children with GHD undergoing rhGH therapy.
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