Designing a Personalized Digital Patient Support Program for Patients Treated With Growth Hormone: Key Design Considerations

• Published in: Journal of medical Internet research 2020-07, Vol.22 (7), p.e18157-e18157
• Main Authors: Malik, Sumaira, Moloney, Clare, Koledova, Ekaterina, Reston, Jonathan, Weinman, John
• Format: Article
• Language: English
• Subjects: Adherence; Behavior; Behavior change; Change agents; Clinical outcomes; Design; Growth hormones; Human Growth Hormone - pharmacology; Human Growth Hormone - therapeutic use; Humans; Insight; Internet; Intervention; Literature reviews; Motivation; Nurse led services; Original Paper; Patients; Physical growth; Pilot Projects; Precision Medicine - methods; Psychosocial Support Systems; Specification; Success; Support services; Systematic review; Telemedicine - methods; Text messaging
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/18157

Recombinant human growth hormone treatment can optimize growth potential; however, optimal outcomes are not always achieved for several reasons, including poor adherence. The overall objective of this project was to design a patient support program to maximize the chances of treatment success for people being treated with somatropin injection. An approach known as the behavior change wheel was used to enhance the development of the patient support program. The behavior change wheel provided a comprehensive framework to support the design of interventions. The aim of this paper was to describe how the steps of the behavior change wheel were applied to the development of a patient support program for individuals with growth hormone deficiency undergoing treatment with somatropin. We followed a series of steps that align to tenets of the behavior change wheel, namely, a narrative literature review to identify which behaviors needed to change and the potential drivers of and barriers to the behaviors, the selection of an intervention strategy and discrete behavior change techniques, and, finally, intervention specification. A recent systematic review identified a range of potentially modifiable factors found to have an influence on patient adherence to growth hormone treatment. Insights from the systematic review were used to guide the development of a patient support program. The final design of the patient support program consisted of four elements: (1) a personalization questionnaire to tailor support for each individual, (2) tailored reminder and support SMS text messages, (3) nurse-led phone calls, and (4) Easypod connect, an automated electronic autoinjector drug-delivery device with a transmitter and connection platform for Saizen (somatropin) that allows automatic recording, storage, and transmission of drug-usage data, thus providing insight into suboptimal adherence. The patient support program that was designed is currently being piloted with patients to assess engagement with the program and determine its impact on patient outcomes. Results from the pilot will be used to further refine the program to ensure it meets user needs.