A daily growth hormone (hGH) is a hormone that is released by the pituitary gland and helps regulate the body’s metabolism. It also plays a role in the development of various organs and body systems. The amount of growth hormone in a human body decreases as one ages, leading to shortening of one’s stature. Many men and women take hGH therapy to boost their bodies’ natural production of growth hormones. However, there are some issues to consider before taking hGH.
Adherence to hGH treatment
Adherence to daily growth hormone treatment is essential to improve stature in children with growth hormone deficiency. Studies have shown poor adherence to r-hGH is associated with lower growth gains and increased health costs. Therefore, strategies for increasing adherence may improve clinical outcomes. In this article, we examine some of these strategies.
There is a considerable methodological heterogeneity in the studies of GH adherence. Some studies have not reported adherence calculations, and others use survey-based estimates. Other studies have used electronic monitoring devices to measure adherence. These devices allow accurate surveillance of adherence, thereby optimizing the use of r-hGH treatment.
Adherence to r-hGH therapy is a critical factor in its efficacy and is likely to be affected by the child’s underlying diagnosis. Low adherence is also a factor in a failure to achieve full height potential. Various factors, such as age, race, and gender, can affect adherence to treatment.
The adequacy of GH adherence has been associated with growth velocity, as well as the serum levels of IGF-1. This relationship has been investigated in two studies. However, IGF-1 levels did not correlate with final height.
Treatment adherence has been classified into three phases. The first phase is initiation. The second phase is fair adherence, characterized by 75 to 85% compliance; the third phase is poor adherence, characterized by 1-3 missed doses per week.
Adherence to somatropin has been estimated to be suboptimal in some adolescents. A study that measured the rate of non-adherence with somatropin found that 33% of adolescents failed to adhere to treatment. Suboptimal adherence has been suggested to be even higher for black children and Hispanic children.
Although many interventions have been carried out to increase adherence, there are several strategies to improve adherence. These include user-friendly devices, improved patient acceptability, and improved self-administration. Several studies have been conducted to explore adherence to r-hGH, including patient/caregiver self-report surveys, electronic monitoring devices, and questionnaires. It is important to understand the complexities of adherence in order to better facilitate improved clinical outcomes.
Despite its shortcomings, the real-life monocentric approach is a strength of the study. Data-sharing agreements allowed for creation of models based on real-world data.
LAGH treatment may improve medication adherence
Medication adherence is an important component in the management of chronic diseases. In addition to the health consequences for the patient, nonadherence can have negative effects on the health care system. A wide range of interventions have been developed to improve adherence, including team-based care and behavioral contracts.
One intervention that has been shown to significantly increase medication adherence rates is the integration of medication reconciliation into primary care. This intervention involves a pharmacist resolving issues and questions from the patients about their medications.
Other approaches have included addressing the broader reasons for nonadherence. Studies have shown that adherence rates can be improved by reducing economic barriers and by recognizing populations at higher risk for nonadherence.
There are many factors that contribute to nonadherence, including the complexity of the treatment, the severity of the disease, and the patient’s ability to understand what is required of them. Patients are often confused and may not be ready to follow all aspects of their regimen.
To determine adherence, doctors should look at patient’s behaviors. Patients may forget to take medication, change their dose, or even mix medications. They can also be fearful of taking medication. As a result, physicians should consider implementing a adherence plan at an early stage in treatment.
It is important to remember that the most basic method to increase adherence is to educate the patient about the importance of taking their medications. Having the patient share their decision-making principles is another way to enhance adherence.
Patient education is particularly important if the patient has a low level of health literacy. Health literacy is a problem among racial and ethnic minorities, those living in poverty, and those with limited income.
Increasing adherence can be achieved by using simple methods, such as giving patients a schedule of the intake of their medications. The schedule should include a list of what to expect and when. Additionally, the schedule should be accompanied by a “contract” between the patient and the provider, stating the consequences of nonadherence.
Using a medication adherence “contract” can help patients to better understand their medications and their role in their disease. A patient should be reminded to bring all of their medications to every visit.
Long-acting growth hormones
Long acting growth hormones (LAGH) are the latest rage in the GH department. The industry is trying to create a GH that is more consistent and less frequent in order to improve the patient’s experience with the therapy. Using a more consistent dosing schedule may be the best way to minimize the likelihood of discontinuation. Despite the hype, studies have shown that adherence to a GH regimen can be as low as 30 percent. To avoid this pitfall, a GH-trained patient should be aware of the risks associated with missing a dose and take preventive measures. In addition, patients may benefit from the use of an electronic dosing system to ensure that they are accurately dispensed their dose.
The industry has been on the trail of creating a long-acting version of the growth hormone since at least the mid-1980s. A recent review of GH technology in the 21st century concluded that, “The efficacy and receptiveness of GH for children and adolescents with growth hormone deficiency has been demonstrated.” GH is also used to treat the various etiologies of short stature. While the GH industry has been a tad slow in the past, GH is still considered to be one of the most effective medicines available today. Unlike many medications, it is safe for both the young and the old. For instance, a study in older adults found that GH did a better job enhancing their quality of life than glucocorticoids or corticosteroids.
One of the longest lasting GH preparations is Somatrogon(c). This is a man-made or synthetic version of GH produced through recombinant DNA technology. It has been tested in a large scale phase 3 clinical trial that involved 161 treatment-naive pediatric patients with GHD. It has also received FDA approval. As of May 2011, it is the first weekly injectable GH approved by the FDA. On a positive note, it is also the cheapest GH currently available, making it more affordable than it was in the past.
Short stature is a condition in which the height of a child is shorter than the mean height of children of similar age. This condition is often considered idiopathic, meaning that there is no known medical cause for it.
The Food and Drug Administration has approved growth hormone therapy for idiopathic short stature. However, there is little information available on its use for other types of short stature. Some studies have reported that daily injections of growth hormone may worsen psychosocial concerns, especially in short kids.
There are two types of idiopathic short stature. One is constitutional growth delay, which causes small size during childhood and early puberty. In other cases, short stature is caused by malnutrition.
The other type of idiopathic short stature is genetic, or familial. This means that the child’s parents have a condition that prevents them from growing tall. These include chromosomal abnormalities and SHOX deficiency.
Growth hormone is used to treat short stature in both children and adults. Treatment is typically given as an intramuscular injection. It is also available as a synthetic version. To find out more about growth hormone, visit the Cochrane database.
Studies have shown that recombinant growth hormone can improve the velocity of height gain. But, more research is needed to determine the long-term effectiveness of GH treatment.
The Cochrane database is an online resource that contains records of clinical trials and studies. Study authors have reviewed a variety of research on short stature. They looked at 80 studies.
These studies ranged in size from 25 to 440 children. Data on the studies were grouped into categories according to study features. Statistical analysis included 95% confidence intervals.
Overall, results showed no significant differences in insulin-like growth factor binding protein-3 or height standard deviation scores. The only major difference was that long-acting growth hormone replacement therapy was associated with significantly lower insulin-like growth factor binding protein-3 scores.
Other factors that should be accounted for when deciding on whether or not to treat short children with growth hormone are the individual’s age and ethnicity. Individual response to growth hormone therapy is highly variable.