Survey to Investigate Adherence to Growth Hormone Treatment in Children: The Impact of COVID-19 Pandemic

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Eren E., Çetinkaya S., Denkboy Öngen Y., Tercan U., Darcan Ş., Turan H., ...More

60th Annual Meeting of the European Society for Paediatric Endocrinology (ESPE), Rome, Italy, 15 - 17 September 2022, pp.263

  • Publication Type: Conference Paper / Summary Text
  • City: Rome
  • Country: Italy
  • Page Numbers: pp.263
  • Ataturk University Affiliated: Yes


Introduction: Treatment adherence is crucial for the success of

Growth Hormone (GH) therapy. Non-adherence rates have varied

over a wide range from 5% to 80% in the literature. Several factors

may have an impact on treatment adherence. Besides, with the

COVID-19 pandemic that affected the whole world, there were

problems with the hospital admission and routine controls of the

patients who used GH treatment.

Objective: The survey’s primary objective is to investigate

adherence to treatment in patients with GH. The survey will also

investigate potential problems in GH treatment during the


Materials and Methods: The survey was sent to pediatric endocrinologists.

Patient data, diagnosis, history of pituitary surgery,

current GH doses, duration of GH therapy, who administers the

therapy (mother and father, patient), duration of missed doses,

reasons for missed doses as well as problems associated with GH

therapy, and missed dose data in the recent year (after the onset of

the pandemic) and causes were asked. The treatment adherence

category was determined based on missed dose rates over the past

month (0 to 5%, full adherence; 5.1 to 10% moderate adherence;

>10% non-adherence).

Results: 427 cases from thirteen centers were evaluated. The

median age of diagnosis of the cases (56.2% male) was 8.5 (0.13-16)

years. GH treatment indications were isolated GH deficiency

(61.4%), multiple pituitary hormone deficiency (14%), Turner

syndrome (7.5%), idiopathic GH deficiency (7.5%), and SGA

(2.8%), and other (6.8%). GH therapy was administered by 70%

parents and 30% patients. Mean daily dose was 32.3 mcg/kg, the

annual growth rate was 7.52Å}2.7 cm. GH adherence rate was good

(70.3%), moderate (14.7%), and poor (15%), respectively. The reasons

for non-adherence were mainly due to forgetting, being tired,

inability to access medication, and pen problems. It was noteworthy

that the COVID-19 pandemic had a negative effect on adherence

in 22%. The problem with an appointment, taking the

medication, and anxiety about going to the hospital were the main

reasons. There was no difference between genders in the adherence

rate. Non-adherence to GH treatment decreased statistically when

the patient administered the treatment, increased age, the duration

of the treatment, and COVID-19 pandemia. A non-statistical

decrease was found in the annual growth rate as the skip rate


Conclusion: During the COVID-19 pandemic, poor adherence

was found to be 15%, and the duration of hormone use and

advanced age are important factors. The pandemic period negatively

affected compliance.