Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 7, 2020
Date Accepted: May 14, 2020
Designing a personalized digital patient support program (PSP) for patients treated with growth hormone: key design considerations
ABSTRACT
Background:
Recombinant human growth hormone (r-hGH) treatment can optimize growth potential; however, optimum outcomes are not always achieved owing to several reasons, including poor adherence. The overall objective of this project was to design a Patient Support Program (PSP) to maximize chances of treatment success for people treated with somatropin injection. An approach known as the behavior change wheel was used to enhance the development of the PSP. The behavior change wheel provides a comprehensive framework to support the design of interventions.
Objective:
The aim of this paper was to describe how the steps of the Behavior Change Wheel (BCW) were applied to the development of a PSP for individuals with growth hormone deficiency (GHD) prescribed somatropin.
Methods:
We followed a series of steps that align to key tenets of the BCW, namely, to identify what behavior(s) need to change, identify the potential drivers of / barriers to the behavior, selection of intervention strategy and discreet behavior change techniques (BCTs) and finally, intervention specification.
Results:
A recent systematic review has identified a range of potentially modifiable factors, which have been found to influence levels of adherence to growth hormone (GH) treatment. Insights from the systematic review were used to guide the development of a PSP. The final PSP consisted of four key elements 1) a personalization questionnaire to tailor support for each individual, 2) tailored reminder and supportive SMS messages, 3) nurse-coaching calls delivered via telephone and 4) easypod™ connect an automated electronic autoinjector drug delivery device with transmitter and connect platform for Saizen® (somatropin), that allows automatic recording, storage and transmission of drug usage data, thus providing insights into the frequency of suboptimal adherence.
Conclusions:
The PSP is currently being piloted with patients to assess engagement with the program and determine the impact on patient outcomes. Results from the pilot will be used to further refine the program to ensure it meets user needs. Clinical Trial: growth hormone, behavior change wheel, somaptropin, adherence
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