Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: JMIR Pediatrics and Parenting

Date Submitted: Oct 2, 2024
Date Accepted: Aug 17, 2025

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

Enhancing Adherence and Mental Well-Being in Pediatric Growth Hormone Therapy: Feasibility Prospective Observational Study of a Family-Centered Digital Companion

de Arriba Muñoz A, García-Durán AM, Sanz-Aznar P, Quer-Palomas S, Bilionis I, Xifra-Porxas A, Nuñez J, Berrios RC, Fernández-Luque L

Enhancing Adherence and Mental Well-Being in Pediatric Growth Hormone Therapy: Feasibility Prospective Observational Study of a Family-Centered Digital Companion

JMIR Pediatr Parent 2025;8:e67102

DOI: 10.2196/67102

PMID: 41144651

PMCID: 12558418

Enhancing Adherence and Mental Well-being in Pediatric Growth Hormone Therapy: A Feasibility Study of a Family-Centered Digital Companion.

  • Antonio de Arriba Muñoz; 
  • Amalia M García-Durán; 
  • Patricia Sanz-Aznar; 
  • Silvia Quer-Palomas; 
  • Ioannis Bilionis; 
  • Alba Xifra-Porxas; 
  • Joia Nuñez; 
  • Ricardo C Berrios; 
  • Luis Fernández-Luque

ABSTRACT

Background:

Managing a child undergoing Growth Hormone treatment (GHt) can be burdensome for the families, which can lead to psychological problems and poor treatment adherence. Adhera Caring Digital Program (ACDP) is a mobile-based digital health intervention designed to support the physical and mental well-being of families of individuals with chronic conditions.

Objective:

The study presented here aimed to evaluate the clinical feasibility of a digital intervention to support families by focusing on caregivers of children undergoing growth hormone treatment and its impact in treatment adherence.

Methods:

Prospective observational study. A total of 51 caregivers of children undergoing GHt with low adherence (<85%) to treatment were recruited at the Pediatric Endocrinology Unit at the Miguel Servet Children’s University Hospital and enrolled into the ACDP for 3 months.

Results:

A total of 51 parents participated in the digital intervention for 3 months. Using ACDP was associated with a significant adherence increase rate (p-value 0.001). At baseline, all families had suboptimal adherence (below 85%) and after the intervention, 74.5% (n=38) of the families reached optimal levels of adherence. Also, perceived pain of injection was reduced, as well as anxiety and stress. Initially, 21.56% of caregivers reported depression symptoms, categorized as mild (11.76%), moderate (7.84%), and extremely severe (1.96%), whilst post-intervention, there were only 1.96 % that reported depression as “severe” (p= 1.088-4). Anxiety levels at baseline reported by a total of 23.53% of caregivers, as mild (7.84%), moderate (13.73%), and severe (1.96%). After the intervention, only 11.76% reported mild (5.88%) or moderate (5.88%) anxiety levels. Initially, 23.5% of caregivers reported stress as mild (7.84%), moderate (13.72%), and severe (1.96%) stress, and following the intervention, these symptoms reduced to 7.84%, as mild (5.88%) and severe (1.96%).

Conclusions:

The Adhera Caring Digital Program is a promising tool, and it has been demonstrated to significantly increase the adherence rate, adding value to the patient and caregiver journey, and improving the management of the growth hormone deficiency condition while promoting the overall wellbeing of family caregivers. Results show that the digital support provided by the solution significantly increased the quality of life of the caregivers by increasing their psychological, emotional, and social well-being and decreasing their depression, anxiety, and stress symptoms. Clinical Trial: Clinical Trial Registry: NCT04812665


 Citation

Please cite as:

de Arriba Muñoz A, García-Durán AM, Sanz-Aznar P, Quer-Palomas S, Bilionis I, Xifra-Porxas A, Nuñez J, Berrios RC, Fernández-Luque L

Enhancing Adherence and Mental Well-Being in Pediatric Growth Hormone Therapy: Feasibility Prospective Observational Study of a Family-Centered Digital Companion

JMIR Pediatr Parent 2025;8:e67102

DOI: 10.2196/67102

PMID: 41144651

PMCID: 12558418

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.