Medical Department, Merck S.A. (an affiliate of Merck KGaA, Darmstadt, Germany), Buenos Aires, Argentina.
Atlantis Healthcare, London, United Kingdom.
Front Endocrinol (Lausanne). 2023 Apr 6;14:1129385. doi: 10.3389/fendo.2023.1129385. eCollection 2023.
The appropriate use of recombinant human growth hormone (r-hGH) treatment provides an opportunity to improve growth outcomes among pediatric patients with growth hormone deficiency (GHD). However, a major challenge in clinical practice is to adequately recognize and address factors that negatively affect treatment adherence. TUITEK patient support program (PSP) was designed to help caregivers of children diagnosed with GHD to personalize the care pathway, improve adherence, and achieve better outcomes. Effectiveness of TUITEK PSP has been demonstrated previously in a smaller sample (n = 31) in Taiwanese population. Here, we present the results from Argentina.
TUITEK PSP was piloted among 76 caregivers of children with GHD administering r-hGH using easypod™ (Merck KGaA, Darmstadt, Germany) auto-injector device in Argentina. Based on TUITEK personalization questionnaire, caregivers were assigned to high- and low-risk groups across four categories that may influence adherence, including disease and treatment coherence (DTC), self-administration (SA), treatment-related anxiety (TRA), and emotional burden (EB). The caregivers who were included in atleast one high-risk group had the provision of telephone calls with a nurse practitioner every 2 weeks for 3 months. The Wilcoxon signed-rank test was employed to assess changes in questionnaire-based scoring patterns between baseline and follow-up evaluations.
Statistically significant changes ( < 0.05) in questionnaire scores between baseline and follow-up evaluations were observed across the four categories. The mean/median DTC (n = 11) and SA (n = 23) scores changed from 2.45/3 and 2.17/2, respectively, to 4/4, with all the caregivers moving to low-risk group following program completion (100%) for both categories. The mean/median TRA score (n = 40) changed from 3.58/3 to 2.5/2 and 67.5% of patients (27/40) moved to low-risk group. The mean/median EB score (n = 32) changed from 3.69/3 to 3.13/3 however, none of the caregivers moved to low-risk group (0%).
TUITEK PSP is a simple, practical, and time-efficient interventional tool that can be used to address key adherence-related issues among caregivers of children with GHD and provide personalized adherence support. Our findings demonstrate that TUITEK PSP has the potential to improve treatment adherence and self-management, thereby improving growth outcomes in Argentina.
适当使用重组人生长激素(r-hGH)治疗为患有生长激素缺乏症(GHD)的儿科患者提供了改善生长结局的机会。然而,临床实践中的一个主要挑战是充分认识和解决可能影响治疗依从性的因素。TUITEK 患者支持计划(PSP)旨在帮助诊断为 GHD 的儿童的照顾者个性化护理途径,提高依从性并取得更好的结果。之前在台湾的一项较小样本量(n=31)的研究中已经证明了 TUITEK PSP 的有效性。在这里,我们展示来自阿根廷的结果。
在阿根廷,使用 Merck KGaA(达姆施塔特,德国)的 easypod™自动注射器,对 76 名患有 GHD 的儿童的照顾者进行了 TUITEK PSP 的试点。根据 TUITEK 个性化问卷,将照顾者分为四个可能影响依从性的类别中的高风险和低风险组,包括疾病和治疗一致性(DTC)、自我管理(SA)、与治疗相关的焦虑(TRA)和情绪负担(EB)。至少有一个高风险组的照顾者将每两周与护士进行一次电话随访,为期 3 个月。采用 Wilcoxon 符号秩检验评估问卷评分模式在基线和随访评估之间的变化。
在四个类别中,观察到问卷评分在基线和随访评估之间有统计学意义的变化(<0.05)。DTC(n=11)和 SA(n=23)的平均/中位数评分从 2.45/3 和 2.17/2 分别变为 4/4,所有照顾者在计划完成后(100%)都转移到低风险组,这两个类别均如此。TRA 评分的平均/中位数评分(n=40)从 3.58/3 变为 2.5/2,67.5%的患者(27/40)转移到低风险组。EB 评分的平均/中位数评分(n=32)从 3.69/3 变为 3.13/3,但没有照顾者转移到低风险组(0%)。
TUITEK PSP 是一种简单、实用且高效的干预工具,可用于解决 GHD 儿童照顾者的关键依从性相关问题,并提供个性化的依从性支持。我们的发现表明,TUITEK PSP 有可能提高治疗依从性和自我管理,从而改善阿根廷的生长结局。