Growth hormone therapy at the time of Covid-19 pandemic: adherence and drug supply issues

Giavoli, Claudia; Profka, Eriselda; Giancola, Noemi; Rodari, Giulia; Giacchetti, Federico; Ferrante, Emanuele; Arosio, Maura; Mantovani, Giovanna

doi:10.1530/eje-20-0481

Cited by 16 publications

(20 citation statements)

References 11 publications

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“…Relatively surprisingly, data shows that most patients with GH deficiency of all ages, including children and adults, but also transition patients had overall good adherence to GH therapy during the COVID-19 pandemic (55). The authors' explanation of this better than expected adherence in the pandemic compared with previous data was linked to home confinement despite the disruption of clinical care for many patients.…”

Section: Growth Hormone Deficiencymentioning

confidence: 75%

Pituitary Disorders and COVID-19, Reimagining Care: The Pandemic A Year and Counting

Fleseriu

2021

Front. Endocrinol.

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Section: Growth Hormone Deficiencymentioning

confidence: 75%

Pituitary Disorders and COVID-19, Reimagining Care: The Pandemic A Year and Counting

Fleseriu

2021

Front. Endocrinol.

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“…We did not directly assess therapy adherence, but it has previously been described to be suboptimal in pediatric populations [ 24 ]. An increase in GH therapy adherence during the COVID-19 pandemic was reported by Giavoli et al, indicating that home confinement influenced the adherence rate positively [ 25 ]. We therefore speculate that the individuals with PWS received a more continuous GH administration due to more flexible family routines and fewer travels during the lockdown.…”

Section: Discussionmentioning

confidence: 99%

Effects of COVID-19 Lockdown on Weight, Body Composition, and Behavior of Children, Adolescents, and Young Adults with Prader–Willi Syndrome

Mohr

Laemmer

Schulte

et al. 2021

JCM

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To reduce transmission of the coronavirus disease 2019 (COVID-19), many countries implemented lockdowns, causing the closure of childcare services. This study was designed to evaluate the impact of the COVID-19 lockdown in March–April 2020 on children, adolescents, and young adults with Prader–Willi syndrome (PWS) living in Germany. We recruited 180 participants with a genetically confirmed PWS. All families completed a questionnaire, and participants underwent a post-lockdown assessment; the last examination before the lockdown was determined as the pre-lockdown assessment. We used bivariate analyses to compare pre- and post-lockdown outcomes. Weight standard deviation scores (SDSPWS) and body mass index (BMI)-SDSPWS remained stable or even decreased in some age groups. A statistically significant gain in lean body mass (LBM) was found in all groups <18 years of age. We observed an increase in IGF-I and IGFBP-3 concentrations without a significant change in growth hormone (GH) dosage. Most families (95.4%) reported set mealtimes and implementation of structured activities (72.2%) during the lockdown period. We therefore suggest that the favorable development of weight/BMI and LBM was caused by an interplay of a suspected enhanced GH administration and continuous parental commitment. However, more intense behavioral problems were observed in 45.7%, which persisted post-lockdown in 33.7%.

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“…Findings of the potential for increased adherence (as we observed for patients taking tacrolimus and buprenorphine/naloxone) are not without precedent either. A single-center study of patients receiving growth hormone therapy did not identify Covid-related increases in non-adherence (though they did highlight the need for increased caregiver diligence due to supply issues) [20], and increased adherence post-Covid has been reported in a study of 7578 asthma and COPD patients using an inhaler [21]. However, this could be related to patient vigilance in the setting of a pulmonary pandemic.…”

Section: Plos Onementioning

confidence: 98%

Patient Access to Chronic Medications During the COVID-19 Pandemic: Evidence from a Comprehensive Dataset of US Insurance Claims

Clement¹,

Jacobi

Greenwood

2020

SSRN Journal

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Patient access and adherence to chronic medications is critical. In this work, we evaluate whether disruptions related to Covid-19 have affected new and existing patients' access to pharmacological therapies without interruption. We do so by performing a retrospective analysis on a dataset of 9.4 billion US prescription drug claims from 252 million patients from May, 2019 through August, 2020 (about 93% of prescriptions dispensed within those months). Using fixed effect (conditional likelihood) linear models, we evaluate continuity of care, how many days of supply patients received, and the likelihood of discontinuing therapy for drugs from classes with significant population health impacts. Findings indicate that more prescriptions were filled in March 2020 than in any prior month, followed by a significant drop in monthly dispensing. Compared to the pre-Covid era, a patient's likelihood of discontinuing some medications increased after the spread of Covid: norgestrel-ethinyl estradiol (hormonal contraceptive) discontinuation increased 0.62% (95% CI: 0.59% to 0.65%, p<0.001); dexmethylphenidate HCL (ADHD stimulant treatment) discontinuation increased 2.84% (95% CI: 2.79% to 2.89%, p<0.001); escitalopram oxalate (SSRI antidepressant) discontinuation increased 0.57% (95% CI: 0.561% to 0.578%, p<0.001); and haloperidol (antipsychotic) discontinuation increased 1.49% (95% CI: 1.41% to 1.57%, p<0.001). In contrast, the likelihood of discontinuing tacrolimus (immunosuppressant) decreased 0.15% (95% CI: 0.12% to 0.19%, p<0.001). The likelihood of discontinuing buprenorphine/naloxone (opioid addiction therapy) decreased 0.59% (95% CI: 0.55% to 0.62% decrease, p<0.001). We also observe a notable decline in new patients accessing these latter two therapies. Most US patients were able to access chronic medications during the early months of Covid-19, but still were more likely to discontinue their therapies than in previous months. Further, fewer than normal new patients started taking medications that may be vital to their care. Providers would do well to inquire about adherence and provide prompt, nonjudgmental, re-initiation of medications. From a policy perspective, opioid management programs seem to demonstrate a robust ability to manage existing patients in spite of disruption.

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Growth hormone therapy at the time of Covid-19 pandemic: adherence and drug supply issues

Cited by 16 publications

References 11 publications

Pituitary Disorders and COVID-19, Reimagining Care: The Pandemic A Year and Counting

Pituitary Disorders and COVID-19, Reimagining Care: The Pandemic A Year and Counting

Effects of COVID-19 Lockdown on Weight, Body Composition, and Behavior of Children, Adolescents, and Young Adults with Prader–Willi Syndrome

Patient Access to Chronic Medications During the COVID-19 Pandemic: Evidence from a Comprehensive Dataset of US Insurance Claims

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