ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2011) 27 P7

Effect of patient choice and hospital tracking on short term growth in children treated with GH therapy

Navoda Atapattu1, Angela Casey1, Julia Prior1, Isobel Howarth2, Rani Zia1, Saeeda Akhtar1, Paul Davies1 & Jeremy Kirk1

1Birmingham Children’s Hospital, Birmingham, UK; 2Pfizer, Surrey, UK.

Introduction: Most (89%) UK units offer some form of free patient choice for new paediatric patients commencing GH therapy. Initial data indicates that patient choice improves adherence, resulting in improved growth (height velocity) short-term.

Objective: To compare outcome measures between patients offered free choice and/or hospital supply (including home services and adherence tracking assessed using ampoule counting) with GH therapy with those who did not.

Methodology: Background data was obtained from the KIGS data base and also hospital notes and endocrine records. Height S.D., height velocity (HV) and HV S.D. were calculated using the growth analyzer version 3.

Results: There were four groups of patients: i) no patient choice but hospital supply (n=53). ii) No patient choice nor hospital supply (n=193). iii) Patient choice and hospital supply (n=97). iv) No hospital supply but patient choice (n=19).

Median (95% CI) Δ height S.D. at 1 year of treatment was significantly different (P=0.03) between the group offered either patient choice or hospital supply(0.51, (0.43, 0.59)) compared with those getting neither (0.40, (0.33, 0.46)). There was, however, no additional growth advantage conferred by offeringboth patient choice and hospital supply (0.47, (0.37, 0.57) compared to offering just one option (medians 0.53 and 0.59 respectively). There was also no significant difference in Δ height S.D. at 1 year of treatment between the different GH products (P=0.949). Height velocity change at 1 year of treatment was not significantly different between the groups (P=0.319).

Conclusion: The GH type had no significant effect on change in height S.D. at 1 year of treatment. Receiving either hospital supply or patient choice produced a significant effect in height S.D. at 1 year of treatment compared with neither, but there was no extra benefit in combination.