国家儿童生长激素治疗患者选择审计。

National audit of patient choice in pediatric GH therapy.

机构信息

Department of Endocrinology, Hospital for Sick Children, Great Ormond Street, London, UK.

出版信息

Horm Res Paediatr. 2011 Feb;75(2):101-5. doi: 10.1159/000318784. Epub 2010 Sep 2.

DOI:10.1159/000318784

PMID:20814188

Abstract

BACKGROUND

To assess free patient choice for pediatric patients commencing growth hormone (GH) therapy within the UK and Republic of Ireland.

METHODS

A semistructured questionnaire was sent to all members of the British Society for Paediatric Endocrinology and Diabetes.

RESULTS

Of 55 units responding, three do not commence patients on GH. The remaining 52 units included 21 from (all) historic growth centres, 13 from other tertiary centres, and 18 from district general hospitals. 46/52 units (89%) offer free patient choice, involving: demonstration of devices (n = 15), instructional DVDs (6), a combination of both (20), or other (3). Median (range) time spent choosing the GH device was 60 (25-150) min. Device demonstration involved: dialling up doses (39 units), assembling/dissembling (38), GH reconstitution (33), considering facilities provided by manufacturer (25), injecting patient (19), injecting parent (17), showing additional material (11), and cost consideration (4). Median (range) number of steps shown per unit was 5 (1-8), with correlation between numbers of manufacturers/devices and new patients commenced on GH per unit (R = 0.62 and 0.61, both p < 0.01), but not with time spent showing devices (R = 0.12 and 0.22, p > 0.05).

CONCLUSION

Most units now offer some form of patient choice for new patients commencing GH therapy, although this involves several different methods, with larger units offering more manufacturers and more devices.

摘要

背景

评估英国和爱尔兰共和国开始生长激素（GH）治疗的儿科患者的自由选择。

方法

对半结构问卷发送给所有英国儿科内分泌学会成员。

结果

在 55 个回应的单位中，有 3 个不开始给患者使用 GH。其余 52 个单位包括 21 个来自（全部）历史生长中心，13 个来自其他三级中心，18 个来自地区综合医院。52 个单位中的 46/52 个（89%）提供自由的患者选择，涉及：设备演示（n=15）、教学 DVD（6）、两者的组合（20）或其他（3）。选择 GH 设备的中位数（范围）时间为 60（25-150）分钟。设备演示涉及：剂量拨号（39 个单位）、组装/拆卸（38）、GH 再配置（33）、考虑制造商提供的设施（25）、给患者注射（19）、给家长注射（17）、展示额外的材料（11）和考虑成本（4）。每个单位显示的步骤中位数（范围）为 5（1-8），每个单位的制造商/设备数量与开始使用 GH 的新患者数量之间存在相关性（R=0.62 和 0.61，均 p<0.01），但与显示设备的时间无关（R=0.12 和 0.22，p>0.05）。