Endocrine Abstracts

Background and objective: Human recombinant growth hormone (hrGH/GH) is an injectable medication used commonly for growth hormone deficiency (GHD) and other health conditions that reduce growth and adult height. Daily GH injections can burden families and result in poor adherence. This study was conducted to investigate caregivers’ experiences, attitudes and preferences regarding pediatric GH treatment. At the time of data collection, the long-acting GH products were not available on the market.

Methods: This survey to the caregivers of under-aged patients using GH was conducted in 50 community pharmacies across Finland between June 2021 and April 2022. Caregivers were identified in pharmacies when purchasing GH. They were asked to complete an anonymous semi-structured electronic questionnaire on a tablet computer.

Results: Total of 78 caregivers responded to the survey. Mean age of the children on GH treatment was 10.1 years (range 2–17 years). Two thirds (65.4%) of them were boys. Most common indications for GH treatment were GHD (67.9%) and small for gestational age without catch-up growth (10.3%). Two thirds (67.9%) of children had been using GH for 3 years or longer, and one third (32.1%) for 2 years or less. All caregivers were very satisfied (70.5%) or quite satisfied (29.5%) with the GH treatment. However, three out of four caregivers (74.4%) reported at least one challenge related to the GH treatment. The most common challenges were administration by injection (35.9%), cold storage requirement (35.9%), high price (16.7%) and child’s unwillingness to take GH (10.3%). Caregivers were asked to describe in their own words an as good and well functioning GH treatment they can think of. Open answers were categorized and quantified. Most frequently mentioned attributes were less frequent dosing interval (25.6%), storage in room temperature (24.4%) and easy-to use dosing device (23.1%). Also good response (11.5%), different administration route, such as cream or tablet (9.0%) and few adverse effects (7.7%) were mentioned.

Conclusions: All caregivers were satisfied with the GH treatment. However, nearly 75% of the responders identified treatment-related challenges. The most frequently reported challenge was the mode of administration (injection). When describing optimal GH treatment, the wish for a less frequent dosing interval was the most often mentioned. Data from this survey can provide support in selecting the optimal type of GH treatment for paediatric and adolescent patients.