Department of Paediatrics, University of Cambridge, Cambridge, UK.
Horm Res Paediatr. 2013;79(4):189-96. doi: 10.1159/000350251. Epub 2013 Apr 30.
Growth hormone (GH) therapy is used to treat a variety of growth disorders in childhood/adolescence. Its efficacy is thought to be dependent on patients' adherence to their treatment regimen.
PubMed was searched using the keywords 'growth hormone', 'child'[Mesh], 'adolescent'[Mesh], and 'patient compliance'[Mesh].
Most studies of adherence to paediatric GH therapy have used either issued/encashed GH prescriptions or questionnaires. Estimates of prevalence of non-adherence vary from 5-82%, depending on the methods and definitions used. Different studies have variously demonstrated an association (or lack thereof) between adherence and age, socioeconomic status, treatment duration, injection device used and injection-giver. A number of interventions have been proposed to improve adherence, including offering a choice of injection device, but none are supported by trials. Poor adherence is associated with reduced height velocity and likely increased economic costs; evidence for other effects is circumstantial.
Adherence to paediatric GH therapy is suboptimal, which may partially explain why the mean final height attained is below that of the general population. Analysis of the causes of non-adherence is complicated by conflicting evidence from different studies. Multifactorial interventions are most likely to be successful in improving adherence. We make recommendations for further research.
生长激素（GH）治疗被用于治疗儿童/青少年时期的多种生长障碍。其疗效被认为依赖于患者对治疗方案的坚持。
使用关键词“生长激素”、“儿童”[Mesh]、“青少年”[Mesh]和“患者依从性”[Mesh]在 PubMed 上进行搜索。
大多数关于儿科 GH 治疗依从性的研究都使用已开出/已兑现的 GH 处方或调查问卷。根据使用的方法和定义，不依从的患病率估计从 5%到 82%不等。不同的研究表明，依从性与年龄、社会经济地位、治疗持续时间、使用的注射装置和注射者之间存在关联（或不存在关联）。已经提出了许多改善依从性的干预措施，包括提供注射装置的选择，但没有一项干预措施得到试验的支持。依从性差与身高速度降低有关，可能会增加经济成本；其他影响的证据是间接的。
儿科 GH 治疗的依从性不理想，这可能部分解释了为什么达到的最终平均身高低于一般人群。对不依从原因的分析因来自不同研究的相互矛盾的证据而变得复杂。多因素干预最有可能成功提高依从性。我们提出了进一步研究的建议。
