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儿童生长激素缺乏症:理解患者和照顾者的观点。

Pediatric growth hormone deficiency: Understanding the patient and caregiver perspectives.

机构信息

M Health Fairview Masonic Children's Hospital, University of Minnesota Medical School, Minneapolis, MN 55455, USA.

Novo Nordisk Inc, Plainsboro, NJ 08536, USA.

出版信息

Growth Horm IGF Res. 2024 Jun;76:101592. doi: 10.1016/j.ghir.2024.101592. Epub 2024 Apr 16.

Abstract

Childhood growth hormone deficiency (GHD) is a rare disorder associated with significant burden on both patients and caregivers. Although previous reports have detailed aspects of the burden experienced by patients and their caregivers, there is a paucity of first-hand information on the patient and caregiver journeys from their respective voices. To address this need, an advisory board meeting was conducted on September 30, 2022, with 4 pediatric patients with GHD and their caregivers to discuss their experiences prior to GHD diagnosis, during the diagnostic process, and during ongoing treatment with recombinant growth hormone. Feedback from patients and caregivers was reviewed by pediatric endocrinologists, who provided their own perspectives on the patient and caregiver journeys based on the information reported. Despite the small sample size, important insights were obtained: patients and caregivers reported remarkable growth benefits achieved with treatment, which provided strong motivation to remain adherent to daily injection regimens. Patient and caregiver accounts reflected wide variability between families in time from suspicion to diagnosis and in treatment challenges faced, ranging from practical issues such as handling and administration of medication to broader concerns about treatment access and continuity, as well as key knowledge gaps among patients, caregivers, and clinicians. Recommendations are provided to enhance the patient and caregiver journeys, including increasing development and availability of educational materials, providing opportunities for patient advocacy by clinicians and health care providers, and encouraging institutional improvements to ensure that patients continue to receive uninterrupted treatment during their critical period of growth.

摘要

儿童生长激素缺乏症(GHD)是一种罕见的疾病,会给患者和照顾者带来沉重的负担。尽管之前的报告详细描述了患者及其照顾者所经历的负担的各个方面,但从患者和照顾者的角度来看,他们的经历的第一手信息却很少。为了满足这一需求,2022 年 9 月 30 日举行了一次顾问委员会会议,邀请了 4 名患有 GHD 的儿科患者及其照顾者参加,讨论他们在 GHD 诊断前、诊断期间以及接受重组生长激素治疗期间的经历。儿科内分泌学家审查了患者和照顾者的反馈意见,并根据报告的信息提供了他们对患者和照顾者经历的看法。尽管样本量较小,但仍获得了重要的见解:患者和照顾者报告了治疗带来的显著生长益处,这为他们坚持每天注射治疗方案提供了强大的动力。患者和照顾者的叙述反映了家庭之间从怀疑到诊断的时间以及治疗面临的挑战存在很大差异,范围从处理和管理药物等实际问题到更广泛的治疗机会和连续性问题,以及患者、照顾者和临床医生之间的关键知识差距。会议提出了一些建议,以改善患者和照顾者的经历,包括增加教育材料的开发和可用性,为临床医生和医疗保健提供者提供患者宣传的机会,并鼓励机构改进,以确保患者在生长关键期继续接受不间断的治疗。

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