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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jan 26, 2021
Date Accepted: Apr 11, 2021

The final, peer-reviewed published version of this preprint can be found here:

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

Dimitri P, Fernandez-Luque L, Banerjee I, Bergadá I, Calliari LE, Dahlgren J, de Arriba A, Lapatto R, Reinehr T, Senniappan S, Thomas-Teinturier C, Tsai MC, Anuar Zaini A, Bagha M, Koledova E

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

J Med Internet Res 2021;23(5):e27446

DOI: 10.2196/27446

PMID: 34014174

PMCID: 8176345

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

  • Paul Dimitri; 
  • Luis Fernandez-Luque; 
  • Indraneel Banerjee; 
  • Ignacio Bergadá; 
  • Luis Eduardo Calliari; 
  • Jovanna Dahlgren; 
  • Antonio de Arriba; 
  • Risto Lapatto; 
  • Thomas Reinehr; 
  • Senthil Senniappan; 
  • Cécile Thomas-Teinturier; 
  • Meng-Che Tsai; 
  • Azriyanti Anuar Zaini; 
  • Merat Bagha; 
  • Ekaterina Koledova

ABSTRACT

Background:

The use of technology to support health and healthcare has grown rapidly in the last decade, across all ages and medical specialties. Newly-developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder.

Objective:

Our objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone (GH) therapy.

Methods:

A total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops on the use of eHealth in management of growth disorders, conducted during 2020, which were structured to provide insights on existing challenges, opportunities and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy.

Results:

A total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent GH therapy stages of the patient pathway, relating to physicians, nurses, and patients/parents and caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during GH therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted and used in clinical practice, but implementation issues (e.g. adaptation to specific clinical settings) must be addressed.

Conclusions:

The use of eHealth in GH therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential to implement use and develop evidence that eHealth tools provide value across the patient pathway.


 Citation

Please cite as:

Dimitri P, Fernandez-Luque L, Banerjee I, Bergadá I, Calliari LE, Dahlgren J, de Arriba A, Lapatto R, Reinehr T, Senniappan S, Thomas-Teinturier C, Tsai MC, Anuar Zaini A, Bagha M, Koledova E

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

J Med Internet Res 2021;23(5):e27446

DOI: 10.2196/27446

PMID: 34014174

PMCID: 8176345

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