Self-reported vs electronically-recorded adherence to GH therapy

Abstract

Introduction: Adherence to the prescribed injection schedule is critical for the success of treatment of growth disorders with recombinant human growth hormone (r-hGH), so monitoring adherence is an important component of effective management.
 Methods: We directly compared self-reported injection adherence data with data recorded from a digitally enhanced electromechanical injection device and software – the easypod™ connect system. Patients with an active easypod™ connect account were identified in seven Latin American countries. Participants completed a survey requesting data including recollection of the number of doses missed in the previous month. These data were compared with the electronically captured date, time, and dose administered by easypod™.
 Results: Of 402 patients receiving r-hGH treatment, 337 (84%) had an active easypod™ connect account and 301 completed the survey. The self-reported adherence data showed that overall, patients or their parents/caregivers believed that their average rate of adherence was 90.5%, equivalent to missing approximately 33 doses a year, or one month of treatment. The easypod™ data showed that the average adherence rate was 80.9%, equivalent to missing 67 injections, or approximately 2 months of treatment, per year.
 Conclusions: Our results show that patients over-estimate their own adherence by ~10%. This disparity between perceived and actual adherence represents approximately one month of missed injections a year, which is likely to lead to sub-optimal growth and clinical outcomes. Electronic monitoring with the easypod™ connect system appears to be an effective technique for identifying low adherence, providing HCPs with the opportunity of intervening to help patients improve their adherence.