Objective

Adherence to treatment regimen is a key factor in the success of Growth Hormone (GH) therapy. Our objective was to assess the long time adherence to treatment in a large cohort of patients.

Design

It is a retrospective study. The data was collected from a single central computerized data center well maintained and checked for quality. All patient aged 1–16 years, treated with GH during 2006–2015 for >2 years, who were insured by “Clalit” Health Maintenance Organization. Adherence was measured by the number of months of pharmacy purchased GH annually: good (11−12), moderate (7–10), and poor (<7) months per year.

Results

2263 patients (59% males) were treated for >2 years. Mean age at treatment initiation was 8.3 ± 3.6 years, 74% were secular Jews, 6.8% ultra-religious Jews and 18.9% of Arab origin.

Only 30% of patients had good adherence to GH therapy. Patients who started treatment before age 8 years had poorest adherence rate.

No association was found between adherence to GH therapy and gender or socioeconomic status.

In a multivariate analysis (gender, age groups, ethnicity and clinic SES) we found the ultra-religious population had higher risk for non adherence (OR 2.16, CI 95% 1.46–3.19). The poorest adherence by age was in the youngest patients.

In patients treated for >5 years (n = 668), adherence rate declined slightly over the years.

Conclusions

Long term adherence to GH therapy is suboptimal. Measures for improving adherence especially among younger and ultra- religious patients are needed.

中文翻译：

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大型健康维护组织队列中长期坚持生长激素治疗。

目的

坚持治疗方案是生长激素（GH）治疗成功的关键因素。我们的目标是评估大量患者对治疗的长期依从性。

设计

这是一项回顾性研究。数据是从单个维护良好的中央计算机数据中心收集的，并检查其质量。由“ Clalit”健康维护组织为2006年至2015年期间接受GH治疗超过2年的所有1-16岁的患者进行了GH治疗。依从性是通过每年购买GH的药房月数来衡量的：每年好（11-12），中（7-10）和差（<7）个月。

结果

2263名患者（59％的男性）接受了2年以上的治疗。开始治疗时的平均年龄为8.3±3.6岁，其中74％为世俗犹太人，6.8％为超宗教犹太人和18.9％的阿拉伯血统。

只有30％的患者对GH治疗有良好的依从性。在8岁之前开始治疗的患者依从性最差。

在坚持GH治疗与性别或社会经济地位之间未发现关联。

在多变量分析（性别，年龄组，种族和临床SES）中，我们发现超宗教信仰人群的不依从风险更高（OR 2.16，CI 95％1.46–3.19）。依年龄最差的依从性是最年轻的患者。

在接受治疗> 5年的患者（n = 668）中，这些年来依从率略有下降。

结论

长期坚持GH治疗并不理想。需要采取措施，尤其是在年轻和超宗教信仰的患者中改善依从性。