Low Treatment Adherence in Pubertal Children Treated with Thyroxin or Growth Hormone.
BACKGROUND
Treatment outcome depends largely on treatment adherence (TA). However, studies analyzing TA in chronic endocrine diseases are scarce and controversial in childhood.


METHODS
We studied TA in 103 children treated subcutaneously with growth hormone (GH) and 97 children treated orally with thyroxin. TA was calculated based on the prescription refill rates. The number of GH injections was recorded by an autoinjector device in 23 children treated with GH.


RESULTS
The correlation between recorded TA and calculated TA based on prescription refill rates was very good (p < 0.001, r = 0.83). TA was lower (p < 0.01) in pubertal children compared to prepubertal children and in children self-administering their medication compared to those whose drug was administered by their parents, both in GH- and thyroxin-treated children. Overall, 67% of the pubertal children treated with GH and 58% of the pubertal children treated with thyroxin missed at least 1 dose per week. TA was higher (p < 0.001) in children with thyroxin treatment compared to children treated with recombinant human GH (8 vs. 26% missed >3 doses/week).


CONCLUSIONS
Puberty and self-administration of drugs were negative predictors of TA. Therefore, in puberty, prevention and treatment efforts should be undertaken to improve TA, especially when adolescents administer their drugs themselves.
Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany.
Nina
N
Lass
Thomas
T
Reinehr
D000293:Adolescent; D002648:Child; D003409:Congenital Hypothyroidism / Q000188:drug therapy; D004393:Dwarfism, Pituitary / Q000188:drug therapy; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011627:Puberty; D013967:Thyroiditis, Autoimmune / Q000188:drug therapy; D013974:Thyroxine / Q000627:therapeutic use*
D019382:Human Growth Hormone; D013974:Thyroxine