Initial patient choice of a growth hormone device improves child and adolescent adherence to and therapeutic effects of growth hormone replacement therapy.

Background: It is thought that growth hormone (GH) therapy success depends on the patient's adherence to their treatment regimen, but an optimal approach to improve adherence has not yet been established. Methods: To evaluate the effect of patient choice of a GH device on adherence to GH therapy, we carried out a retrospective longitudinal study of 46 GH deficient patients (24 boys, mean age of commencing GH therapy: 7.70 ± 3.12 years) treated with recombinant GH therapy for 3 years, either with or without patient choice (n = 28, 18, respectively). Results: The group comparison study for adherence, which evaluated the frequency of missed injections based on self-report, revealed that patient choice reduced the proportion of patients with low adherence 3 years after commencing GH therapy (33.3%--7.1%, p = 0.042). Furthermore, this longitudinal study revealed that the patients with choice yielded significantly greater height standard deviation scores (SDS) (ΔHt SDS: 1.34 ± 0.44 vs. 0.92 ± 0.57, p = 0.020) and insulin-like growth factor 1 (IGF-1) SDS (ΔIGF-1 SDS: 2.49 ± 0.75 vs. 1.89 ± 1.13, p = 0.038) than those without choice. Conclusions: These results indicate that patient choice might improve adherence to GH therapy, which improves the therapeutic effects of GH therapy. [ABSTRACT FROM AUTHOR]