Personalized behavioral change technique intervention with TUITEK® patient support program to support caregivers of children treated with growth hormone in Korea (abstract)

Background: Growth hormone (GH) treatment requires long-term self-management and optimized recombinant-human growth hormone (r-hGH) prescription. Patient support programs (PSPs) are vital in educating, providing personalised support to caregivers and enhancing patient care to achieve optimal growth outcomes. Nurse-led PSP calls using behavior change techniques (BCTs) and motivational interviewing principles have demonstrated a meaningful behavior change across different health conditions. Aim: To report the impact of the TUITEK® PSP, a multi-component service involving BCTs on caregivers’ knowledge, beliefs, and perceptions supporting treatment adherence in patients with GH. Method: TUITEK® PSP was evaluated in Korean caregivers of children with growth disorders prescribed with r-hGH (Saizen®, Merck KGaA, Darmstadt, Germany) using Aluetta™ pen device approved by MFDS, Korea. Two PSP nurses were trained by psychologist and applied personalization screener to caregivers to identify issues and challenges faced by patients and caregivers. Caregivers in the high-risk group were offered a set of personalized telephone calls and resource packs with a range of BCTs over 3 months. Caregivers were asked to answer same screener to evaluate the progress at the final survey. Results: Of 34 participants, 97% caregivers (n=33) who managed patients with disease of partial GH deficiency (n=22), idiopathic short stature (n=6) or small for gestational age (n=5) completed the survey. In total, 94% caregivers (n=31) were initially categorized as ‘high-risk’. The percentage of caregivers classified as high-risk for emotional burden (n=23), treatment-related anxiety (n=22) and lower confidence of self-administration (n=23) was reduced significantly by 65%, 77% and 70%, respectively at follow-up. Of 3 caregivers with lower disease coherence, 2 showed improvement in disease coherence at follow-up and lower treatment coherence of 1 participant was improved with nurse coaching. Caregivers of children with co-morbidities (n=7) showed a tendency of requiring interventional calls more frequently than the group without co-morbidities (mean number of calls was 2.6 vs 2.0). Regardless of co-morbidities, the percentage of caregivers scoring as ‘high-risk’ (n=31) was reduced by 82% in at least one of the risk factors at follow-up after educational interventions. Half of the caregivers (52%) were low-risk on all factors at follow-up as compared to 6% at baseline. Conclusion: TUITEK® PSP addressed potential treatment barriers and provided effective interventions with personalized BCT motivational contents. Thus, such PSPs could help caregivers to understand and improve treatment-related knowledge, perceptions, and beliefs and better support adherence-related needs at different stages of GH treatment.