Objective – Many children need chronic medical therapy. Adherence to treatment is a key factor for therapy`s . We tried to assess the long term adherence to growth hormone (GH) therapy in a large cohort.
Methods –All patients aged 1-16 who were treated with GH during the period 2006-2015 for more than 2 years in Clalit Health Services were included.
Adherence was measured using the number of months per year in which GH prescriptions were dispensed. Adherence data was categorized using the cut-offs: good 11 and 12 months, moderate 7-10 months and poor
Results – There were 2263 patients (59% males). Mean age at the beginning of treatment was 8.3+3.6 years, 74% were secular Jews, 6.8% were ultra-orthodox and 18.9% were of Arab origin.
Only 30% of the patients had good adherence to therapy.
Patients who started treatment before age 8 had the poorest adherence rate.
We did not find an association between adherence and gender, socioeconomic status (SES) of clinic, or the indication for treatment.
In a multivariate analysis which included gender, age groups (0-8 years,9-10, 11-12 and 13+ years) origin and SES, we found that being an ultra-orthodox was a risk factors for non-adherence. The poorest adherence was in the youngest age group.
In patients who were treated for more than 5 years (n=668), adherence rate declined over the years (p<0.001)
Conclusions – Long term adherence to GH therapy is suboptimal. Measures for improving adherence especially among younger and extremely religious patients are needed.
