Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 30 P53

BSPED2012 Poster Presentations (1) (66 abstracts)

High rates of non adherence to daily r-hGH injections revealed by the easypod electronic dose record

Sinéad M Bryan


University College London Hospitals NHS Foundation Trust, London, UK.


Background and aims: Non-adherence to daily subcutaneous GH (r-HGH) administration may account for discrepancies between dose prescription, growth response and serum IGF1 levels but is difficult to determine. The electronic r-HGH auto-injector Easypod device has the only inbuilt retrievable dosing record, with which we aimed to assess adherence.

Method: Over a 4 month period, we retrospectively retrieved dose history data in 25 clinic patients aged 10–18 (mean 15) years, who freely chose the Easypod r-HGH delivery method (for a variety of treatment indications). We audited rates of successful injection delivery, reasons for missed injections and contact with the patient’s SENSE home support nurse.

Results: Average days recorded 117.8 (range 27–184).

% Injections missedTotal (n) patientsMean age (range)Mean time on treatment (months)
0317 (16–18)14
1–10914 (10–17)29.5
11– 40615 (13–18)29.3
>41716 (13–18)52.4

Summary: Missed doses were the norm, only a 12% minority being fully adherent even over a short 4 month period. About half missed 10% of doses, but the majority (55%) missed more and a substantial minority (25%) received <60% of their recommended prescription. Adherence deteriorated after the first treatment year and continued to decline to 5 years with no apparent improvement with the SENSE nurse (data not shown).

Conclusion: This small study demonstrates the benefits of inbuilt administration recorders in r-HGH injection devices in assessing growth responses in children. The surprisingly high prevalence of non-adherence, especially after 4 years, is relevant to the cost benefit implications of continued treatment and highlights the importance of addressing patients’ (not parents’ or physicians’) perception of treatment benefit. Switching for a period to the Easypod may allow clinicians to make considered decisions about treatment continuation (and may improve compliance due to the Hawthorn effect).

Volume 30

40th Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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