Abstract
Our purpose was to determine pediatric endocrinologists' knowledge, attitudes, beliefs, and practices (KABPs) regarding recombinant human growth hormone (rhGH) treatment, examine care-related attitude consensus or discordance, and identify evidence-based practice gaps. We developed a survey for National Cooperative Growth Study (NCGS) investigators (N = 711) to elicit their KABPs regarding GH stimulation testing as a diagnostic tool, IGF-1 monitoring for safety and dosing guidance, and pubertal dosing. Responses were compared with NCGS data from the last 20 years. Comparison between survey responses and NCGS data revealed potential discrepancies between expressed opinions and actual practice. In conclusion, this KABP survey, combined with NCGS data, suggests changes over time in diagnostic and rhGH-related therapeutic practices. Variability and inconsistency exist between the survey responses and practice trends over time as reflected in the NCGS database. Further study is necessary to provide evidence to guide rhGH treatment decisions.
Highlights
Therapy with growth hormone, initially derived from cadaveric human pituitary glands, began in the late 1950s and expanded with the availability of recombinant human growth hormone in1985. rhGH therapy for growth disorders in children and, more recently, for replacement or anabolic actions in adults, has been prescribed and monitored primarily by endocrinologists and nephrologists
We developed a survey for National Cooperative Growth Study (NCGS) investigators (N = 711) to elicit their Knowledge Attitudes Beliefs Practice (KABP) regarding GH stimulation testing as a diagnostic tool, insulin-like growth factor 1 (IGF-1) monitoring for safety and dosing guidance, and pubertal dosing
We developed a survey based upon existing evidence gaps and surveyed investigators participating in the phase 4 postmarketing safety surveillance trial, the National Cooperative Growth Study (NCGS), to determine current opinions regarding treatment processes (Attitudes and Beliefs)
Summary
Therapy with growth hormone, initially derived from cadaveric human pituitary glands, began in the late 1950s and expanded with the availability of recombinant human growth hormone (rhGH) in1985. rhGH therapy for growth disorders in children and, more recently, for replacement or anabolic actions in adults, has been prescribed and monitored primarily by endocrinologists and nephrologists. In order to improve the care of children with growth disorders, we sought to identify specific areas in which evidence suggests a need for further study and in which there is great variability in clinical practice. The objectives of our efforts were to determine attitudes and beliefs of pediatric endocrinologists regarding treatment of children receiving rhGH, examine areas of consensus and discordance in attitudes related to care delivery, International Journal of Pediatric Endocrinology and identify gaps in evidence-based practice for quality improvement. We developed a survey based upon existing evidence gaps and surveyed investigators participating in the phase 4 postmarketing safety surveillance trial, the National Cooperative Growth Study (NCGS), to determine current opinions regarding treatment processes (Attitudes and Beliefs). In order to evaluate how Attitudes and Beliefs are translated into clinical practice, we compared the survey responses to actual practice based upon data entered into the NCGS registry (Practice)
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