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Endocrine Abstracts (2016) 45 P67 | DOI: 10.1530/endoabs.45.P67

BSPED2016 Poster Presentations Pituitary and growth (9 abstracts)

Trends in growth hormone prescription in the UK: Results from the 3 year National Growth Hormone Audit

Vrinda Saraff 1 , Sheila Shepherd 2 , Leena Patel 3 & Nick Shaw 1,


1Birmingham Children’s Hospital, Birmingham, UK; 2NHS Greater Glasgow and Clyde, Glasgow, UK; 3Royal Manchester Children’s Hospital, Manchester, UK; 4On Behalf of the BSPED Clinical Committee, Bristol, UK.


Introduction: The National Growth Hormone (GH) audit was initiated in 2013 with funding from BSPED, to establish the ongoing trends in GH prescriptions in the UK and facilitate future long term follow up studies through a central database. Here we have studied the trends in GH prescribing and the indications for treatment from 2013 to 2015.

Method: We examined data collected on a quarterly basis from centres across the UK on subjects less than 16 years of age, newly starting GH therapy.

Results: The number of reporting centres declined by 15% from 2013 to 2015 (79 to 67) with a mean of 904 new GH starters per year. Proportion of subjects starting GH (vs 0-16y population from 2011 Census, Office for National Statistics; % in UK) in constituent countries was England 86% (23.4 m; 84%), Scotland 9% (2.2 m; 8%), Northern Ireland 3% (0.9 m; 3%) and Wales 2% (1.3 m; 5%). General practitioners provided 60% of the ongoing prescriptions.

The most common indication for GH therapy was GH deficiency (56%), followed by Small for gestational age (16%) and Turner syndrome (9%) (Table 1). Off label prescriptions declined by 50% during the 3 year period. Of the total prescriptions, 64% were according to BNF recommended doses for specific indications.

Table 1 Number of subjects (%) starting GH for each indication.
YearGHDTurnerPWSCRISGASHOXOff labelTotal
2013531 (55)84 (9)61 (6)34 (4)144 (15)10 (1)102 (10)966
2014531 (56)100 (10)53 (6)23 (3)148 (16)20 (2)69 (7)944
2015456 (57)78 (10)43 (5)19 (2)141 (18)15 (2)52 (6)804
GHD – Growth Hormone deficiency, PWS – Prader Willi syndrome, CRI – Chronic renal insufficiency, SGA – Small for gestational age, SHOX – Short Stature Homeobox.

Conclusion: The three year GH audit confirms that the majority of prescriptions are for licensed indications. The reasons for 36% prescriptions outside the recommended dose range remain to be explored. Ongoing challenges include maintaining a high return rate to capture optimum data and facilitate long term follow up studies.

Volume 45

44th Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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