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

Endocrine Abstracts (2013) 33 OC2.8 | DOI: 10.1530/endoabs.33.OC2.8

Establishing a national audit of paediatric GH prescribing

Emma-Jane Gault1, Sheila Shepherd2 & Nick Shaw3

1University of Glasgow, Glasgow, UK; 2NHS Greater Glasgow and Clyde, Glasgow, UK; 3Birmingham Children’s Hospital, Birmingham, UK.

Introduction: GH therapy is prescribed to UK children for a variety of indications. However, no central record exists, making follow-up studies difficult.

Aim: To establish an ongoing audit of UK children and adolescents newly-prescribed GH in order to i) monitor trends in prescribing practice and ii) facilitate future long-term follow-up.

Patient population: UK children aged ≤16.0 years newly starting GH therapy.

Methods: Consultants prescribing paediatric GH (BSPED members/non-members) can participate. The following anonymised data are recorded: partial postcode, diagnostic category, sex, month/year of birth, age, GH dose, injections per week, ongoing prescription (GP/hospital). Data are submitted and collated centrally quarterly. Audit ID numbers are allocated and sent to participating centres for local linkage to NHS, CHI or H&C numbers.

Results: Eighty-four centres are participating; for the first quarter (Jan/Feb/Mar 2013), 75 submitted returns (89%), of which 22 had no patients to report. The remaining 53 centres reported 250 patients (M/F: 138/112) treated at a median (range) age of 8.2 (0.2–22.6) years for the following indications.

‘Other’ included short stature (16); syndromes (6) & constitutional delay of growth (2). GH dose is usually calculated as mg/m2 per week or μg/kg per day (both 90), with mg/kg per week less common (68; Table 1). The majority (248) receive daily injections and most ongoing prescribing is via the GP (152 vs 95 hospital).

Table 1 Indication for GH therapy (n).

Table 1 Indication for GH therapy (n).

Conclusion: Early indications are that a national audit of paediatric GH prescribing is feasible. Most treatment is for a licensed indication and initiated at all paediatric ages. Ongoing challenges include maintaining the initial high return rate and auditing local data linkage; fundamental to future follow-up studies.

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