Endocrine Abstracts

Introduction: The somatotropin deficit is one of the late consequences of cancer treatments. The administration of somatotropin implies treatment with daily injections, which hinders therapeutic adherence. This goal is a challenge for survivors and health professionals. Therapeutic education and new technologies are instruments that favor the training and development of control mechanisms that promote and motivate the behavior’s change.

Objective: To evaluate the therapeutic adherence of pediatric oncologic survivors treated with somatotropin in the IPOLFG Rehabilitation Endocrinology Clinic.

Methods: Retrospective, descriptive and analytical study, reviewing of nurse and medical clinical records of children / adolescents under treatment with somatotropin of our Endocrinology Rehabilitation Outpatient Clinic from January/2015 to October/2018.

Development: At present, 57 children/adolescents with a record of 100% therapeutic adherence are under treatment with somatotropin. The use of differentiated and personalized strategies, communication techniques and new technologies in therapeutic education have promoted acceptance and motivation in a therapeutic commitment that has led, especially in the last three years, to a positive result in adherence to this treatment. The device used in Department, Easypod, allows the registration and consequent verification and control of doses prepared and administered giving precision and accuracy to the validation of the respective adhesion. The Easypod Connect platform, which has been recently integrated in the appointments, has proved useful in early detection of cases of non-adherence, allowing a faster intervention in these cases. Nonadherence was identified at the beginning of the treatment, mainly due to the fear of the pain of the bite or due to saturation of treatment time. Sometimes, demotivation with the obtained results, may be also a negative interference. Five cases of partial adhesion and/or non adhesion were identified in this time period. Nursing appointments, were intensified, telephone contacts, adjustment of parameters in the devices (reduction of the time of injection), techniques of pain relief, teaching of distraction techniques, negotiation, positive reinforcement by the obtained results and development of the interpersonal relation for a involvement of children/adolescents and parents in therapeutic goals.

Conclusion: Therapeutic education, new technologies and multidisciplinary teamwork are fundamental for skills development on training administration and consequent success in adherence. Only with this work we can get efficacy and decide about future adjustments of somatotropin doses in children / adolescents. This therapeutic success has repercussions not only on the stature but also on the present and future quality of life of survivors.