Endocrine Abstracts

Introduction: Approximately 3200 children and young people in the UK receive GH therapy. Currently 12 different GH injection devices are available, with NHS guidance (NICE-TA188) recommending that patients/carers should have a choice of product. Whilst there is evidence that offering such choice may improve treatment adherence, little is known about its importance to patients/carers, nor whether device preferences should be reviewed after a period of treatment.

Methods: Patients receiving GH therapy and/or their carers, attending a tertiary paediatric endocrine centre were asked to complete an anonymous questionnaire about their views and preferences regarding choice of injection device. Where appropriate, preferences were rated one (not important) to five (very important).

Results: 100 out 123 eligible patients were randomly approached. 96 patients (mean (range): age 11.8 (1.4–19.0) years, duration GH therapy 3.4 (0–13) years) and carers completed the questionnaire (41 patients, 53 carers). The majority rated choice of GH product at treatment initiation (94%) and the opportunity to review/change GH device after therapy onset (75%) as important (rating 4–5). The most commonly cited attributes for choosing a device were: ease of holding (65%), hidden needle (61%), ready-mixed cartilages (57%), auto-injector (54%), and home delivery service (47%). Preferences for timing of GH device review varied: transition from primary to secondary school (37%), five years (31%) or one year (27%) after starting treatment, and starting college/university (27%). Most (76%) respondents wanted this review to be undertaken at a routine clinic appointment, rather than at a specially-arranged appointment with the endocrine nurses (23%) or through accessing product information (leaflets/DVDs/websites; 11%).

Conclusion: Most young patients on GH therapy and their carers consider choice of injection device to be important and would value the opportunity to review/change device later on. Further research is needed to determine whether this practice affects adherence and long-term treatment outcomes.