title: Understanding Treatment Burden for Children Treated for Growth Hormone Deficiency.
abstract: Growth hormone deficiency (GHD) treatment for children requires growth hormone injections, typically administered daily until the child reaches adult height. Child GHD treatment burden is not well understood and no disease-specific measures exist to assess this burden. The purpose of the study was to explore GHD treatment burden for children and their parents by conducting concept elicitation interviews supporting a theoretical model of the impact of GHD treatment.
  
  
  
  Four focus groups (in Germany) and 52 telephone interviews (in the UK and USA) were conducted with children/adolescents with GHD aged 8 to <13 years and parents of children with GHD aged ≥4 to <13 years. The purpose of the interviews was to understand the experience of GHD treatment from the child's perspective, and for parents, the impact of their child's treatment on themselves. Interview transcripts were analyzed thematically based on modified grounded theory principles.
  
  
  
  Interviews with 70 respondents who produced descriptions (n = 73) of patients experiences with GHD treatment (three parents spoke for two children each) were conducted. Analysis identified three major areas of GHD treatment burden for children: physical; emotional well-being; and interference. Parent burdens identified were: emotional well-being and interference. Modifiers such as treatment efficacy and duration, which may impact the degree of treatment burden severity, were identified.
  
  
  
  Overall treatment burden of child GHD is considerable for children and their parents. The concept elicitation and theoretical model can be used to develop a disease-specific outcome measure, which adequately reflects the burden of GHD treatment for children and their parents.
authors.affiliation: The Brod Group, 219 Julia Avenue, Mill Valley, CA, 94941, USA. mbrod@thebrodgroup.net.
authors.forename: Meryl
authors.initials: M
authors.lastname: Brod
authors.affiliation: Novo Nordisk, Søborg, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Højbjerre
authors.affiliation: The Brod Group, 219 Julia Avenue, Mill Valley, CA, 94941, USA.
authors.forename: Suzanne Lessard
authors.initials: SL
authors.lastname: Alolga
authors.affiliation: The Brod Group, 219 Julia Avenue, Mill Valley, CA, 94941, USA.
authors.forename: Jane F
authors.initials: JF
authors.lastname: Beck
authors.affiliation: Novo Nordisk, Søborg, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Wilkinson
authors.affiliation: Novo Nordisk, Søborg, Denmark.
authors.forename: Michael Højby
authors.initials: MH
authors.lastname: Rasmussen
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009634:Noonan Syndrome / Q000188:drug therapy* / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D057240:Patient Preference; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone
keywords: Focus Group; Growth Hormone; Growth Hormone Deficiency; Noonan Syndrome; Treatment Burden