Urakami Tatsuhiko
Department of Pediatrics, Nihon University Hospital, Tokyo, Japan.
Clin Pediatr Endocrinol. 2021;30(2):85-92. doi: 10.1297/cpe.30.85. Epub 2021 Apr 3.
This multicenter prospective cohort study followed up Japanese children who had just started GH therapy using a drug delivery device (GROWJECTOR® L) linked to a newly developed smartphone application and analyzed precise medication adherence data stored in GROWJECTOR® L to evaluate the usefulness of the application in improving GH therapy adherence over a 24-wk observation period. Moreover, a questionnaire survey on GH therapy and the smartphone application was conducted, and factors affecting adherence to GH therapy were assessed. This study enrolled 60 children with short stature who had GH deficiency or Turner syndrome or were small for gestational age from 28 Japanese medical institutions and analyzed 57 of them. The median and mean adherence rates after 24 wk of observation were 96% and 93%, respectively. Although adherence rates were significantly lower from wk 16 to wk 20 than from wk 1 to wk 4, cumulative adherence rates remained high throughout the observation period. The questionnaire analysis revealed that most patients actively used the application. Overall, our results suggest that active discussion regarding the development of healthcare systems that contribute toward improving the patient quality of life is warranted.
这项多中心前瞻性队列研究对刚开始使用与新开发的智能手机应用程序相连的药物输送装置(GROWJECTOR® L)进行生长激素(GH)治疗的日本儿童进行了随访,并分析了存储在GROWJECTOR® L中的精确用药依从性数据,以评估该应用程序在24周观察期内改善GH治疗依从性的有效性。此外,还进行了一项关于GH治疗和智能手机应用程序的问卷调查,并评估了影响GH治疗依从性的因素。本研究纳入了来自28家日本医疗机构的60名身材矮小且患有GH缺乏症、特纳综合征或小于胎龄儿的儿童,并对其中57名儿童进行了分析。观察24周后的中位依从率和平均依从率分别为96%和93%。虽然第16周和第20周的依从率明显低于第1周和第4周,但在整个观察期内累积依从率仍然很高。问卷调查分析显示,大多数患者积极使用该应用程序。总体而言,我们的结果表明,有必要就有助于改善患者生活质量的医疗保健系统的发展进行积极讨论。