Malik Sumaira, Moloney Clare, Koledova Ekaterina, Reston Jonathan, Weinman John
Atlantis Healthcare, London, United Kingdom.
Endocrinology, Global Medical, Safety and CMO, Merck KGaA, Darmstadt, Germany.
J Med Internet Res. 2020 Jul 29;22(7):e18157. doi: 10.2196/18157.
Recombinant human growth hormone treatment can optimize growth potential; however, optimal outcomes are not always achieved for several reasons, including poor adherence. The overall objective of this project was to design a patient support program to maximize the chances of treatment success for people being treated with somatropin injection. An approach known as the behavior change wheel was used to enhance the development of the patient support program. The behavior change wheel provided a comprehensive framework to support the design of interventions.
The aim of this paper was to describe how the steps of the behavior change wheel were applied to the development of a patient support program for individuals with growth hormone deficiency undergoing treatment with somatropin.
We followed a series of steps that align to tenets of the behavior change wheel, namely, a narrative literature review to identify which behaviors needed to change and the potential drivers of and barriers to the behaviors, the selection of an intervention strategy and discrete behavior change techniques, and, finally, intervention specification.
A recent systematic review identified a range of potentially modifiable factors found to have an influence on patient adherence to growth hormone treatment. Insights from the systematic review were used to guide the development of a patient support program. The final design of the patient support program consisted of four elements: (1) a personalization questionnaire to tailor support for each individual, (2) tailored reminder and support SMS text messages, (3) nurse-led phone calls, and (4) Easypod connect, an automated electronic autoinjector drug-delivery device with a transmitter and connection platform for Saizen (somatropin) that allows automatic recording, storage, and transmission of drug-usage data, thus providing insight into suboptimal adherence.
The patient support program that was designed is currently being piloted with patients to assess engagement with the program and determine its impact on patient outcomes. Results from the pilot will be used to further refine the program to ensure it meets user needs.
重组人生长激素治疗可优化生长潜能；然而，由于多种原因，包括依从性差，并非总能取得最佳疗效。本项目的总体目标是设计一项患者支持计划，以最大限度地提高接受生长激素注射治疗的患者的治疗成功率。一种称为行为改变轮的方法被用于加强患者支持计划的制定。行为改变轮提供了一个全面的框架来支持干预措施的设计。
本文旨在描述行为改变轮的步骤如何应用于为接受生长激素治疗的生长激素缺乏症患者制定患者支持计划。
我们遵循了一系列与行为改变轮原则相一致的步骤，即进行叙述性文献综述，以确定哪些行为需要改变以及这些行为的潜在驱动因素和障碍，选择干预策略和离散的行为改变技术，最后进行干预规范制定。
最近的一项系统评价确定了一系列被发现会影响患者对生长激素治疗依从性的潜在可改变因素。该系统评价的见解被用于指导患者支持计划的制定。患者支持计划的最终设计包括四个要素：（1）一份个性化问卷，为每个个体量身定制支持；（2）量身定制的提醒和支持短信；（3）护士主导的电话；（4）Easypod connect，一种带有发射器和用于赛增（生长激素）的连接平台的自动电子自动注射给药装置，可自动记录、存储和传输用药数据，从而深入了解依从性不佳的情况。
目前正在对设计的患者支持计划进行试点，以评估患者对该计划的参与度，并确定其对患者治疗结果的影响。试点结果将用于进一步完善该计划，以确保其满足用户需求。
