Abstract
Background: It is important to identify patients with low adherence to recombinant human growth hormone (r-hGH) therapy and initiate actions to improve adherence. The Merck Patient Support Program (PSP) aims to raise the awareness of these patients and their parents of the importance of good adherence in achieving optimal growth outcomes. The easypod™ digitally-enhanced injection device provides accurate, reliable adherence data for the PSP by recording the exact dose, time and date of injections given. In this study, we aimed to measure the effect of an educational intervention on adherence in patients using the easypod™ device to deliver their r-GH therapy.Methods: This was a 12-month observational, retrospective cohort study. Patients previously identified by data recorded from their easypod™ injection device as having low adherence (<80%) were followed over the 6 months before and after a targeted educational visit by a PSP nurse. Patient adherence and demographic data were extracted from the PSP database. Statistical analyzes were carried out with STATA 15.0 software.Results: Data from 80 patients (65% male) with low adherence were analyzed. Patients were aged 2–18 (mean: 11.77) years with diagnoses of growth hormone deficiency (71.25%), small for gestational age (20%), Turner syndrome (7.50%) and chronic renal disease (1.25%). Duration of treatment was 0.40–11.13 (median: 3.62) years. At baseline, median adherence to r-hGH therapy was 67%; after the intervention it increased to 76%, a statistically significant median improvement of 9% (p = 0.0000, Wilcoxon signed-rank test). Additionally, 36% (29/80) of patients increased their adherence to r-hGH therapy to ‘good’ (≥80%). Both changes were clinically relevant.Conclusions: We conclude that a nurse-led educational intervention, supported by digital medication adherence monitoring, is a simple method to improve adherence to r-hGH therapy, and recommend this intervention to reduce the gap between the indication/recommendation of the specialist and patients' behavior.
Highlights
The success of treatment for any chronic disease depends not just on the effectiveness of the medication and on the patient’s adherence to the treatment regimen over the long periods involved [1, 2]
The adherence rates before and after the intervention showed that the nurse visit had a positive result, as median adherence was increased by 9% for three parameters: adherence to injections, dose, and injection regimen (Table 3)
Our study demonstrates the value and effectiveness of the combination of innovative digital adherence monitoring devices and targeted educational interventions during the course of treatment in children with growth disorders
Summary
The success of treatment for any chronic disease depends not just on the effectiveness of the medication and on the patient’s adherence to the treatment regimen over the long periods involved [1, 2]. It can be due to fear of side-effects, forgetfulness, erratic lifestyle, variations in the severity of the disease itself, the complexity of the treatment regimen, or the perceived unpleasantness of the method for taking the medication, when this involves injections [1]. A common definition of good adherence is taking ≥80% of the number of doses prescribed by the physician over the relevant time period [4]. We aimed to measure the effect of an educational intervention on adherence in patients using the easypodTM device to deliver their r-GH therapy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
