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Abstract:
ObjectiveThere is a paucity of studies on adherence to growth hormone
treatment in growth hormone deficient (GHD) adults. Therefore, this
study reports on adherence to GH-replacement therapy in adults with GHD,
with a special focus on the course and potential predictors of
nonadherence.
DesignRetrospective single-centre cohort study.
PatientsFrom the local patient database, 179 suitable patients with GHD
were identified.
MeasurementsThe primary outcome was adherence assessed by calculating
the percentage of available prescription data in comparison with
recommended GH dosages over a mean follow-up period of 924 months.
Patients were categorized into five adherence categories ranging from
<20% to >80%.
ResultsMean overall adherence was 740%, with 529% of patients falling
into the adherence group of >80% and 88% of <20%. There was a
significant drop in adherence (98%) between the first and second years
of treatment (P < 0001). Patients with childhood-onset GHD were
significantly less adherent to GH treatment than patients with
adult-onset GHD (620% vs 770%, P = 0012); however, this finding was no
longer significant after including age as a covariate. Frequency of
IGF-1 levels lying outside the age- and sex-specific reference range was
not a good indicator for adherence.
ConclusionAlthough overall adherence was relatively high in our study
sample, there is a significant amount of patients who should be regarded
as nonadherent. This applies in particular to younger patients. Treating
physicians should be aware of the fact that IGF-1 levels do not seem to
be a good indicator for adherence.
