The Impact of Nurse-Led Support for Carers of Children Taking Growth Hormone Treatment

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The Impact of Nurse-Led Support for Carers of Children Taking Growth Hormone Treatment

Evidence for Change

Evidence for Change provides a quick, evidence-based overview of key behavioural science research that Atlantis Health applies in supporting patients to achieve optimal health outcomes.

Dr Debbie Cooke is the Head of Health Psychology at Atlantis Health UK, leading a team of behavioural science and health psychology experts to bring the latest evidence-based interventional approaches in developing and building optimised patient support solutions that empower people living with long-term conditions to create Change for Good.

Research selected

“The TUITEK® patient support program improved caregiver-related behaviors on growth hormone treatment adherence” Koledova, E., Su, P-H., Chen, Y-J., Assefi, A., Debicki, M., Cooke, D., Jheeta, A., Jones, A. B., & Moon, J. E. (2025). Frontiers in Endocrinology, 16, 1548558.

Relevance today

Challenge: Poor adherence to recombinant human growth hormone (r-hGH) treatment among children with growth hormone deficiency remains a significant challenge despite its potential benefits for improving growth outcomes. This often happens because carers might not fully understand the condition or treatment, or they may lack confidence in managing the treatment for their child long-term.

The TUITEK® Patient Support Programme was created to address these issues. The programme uses behavioural science-based interventional techniques and was delivered by highly skilled and dedicated nurse practitioners who provided personalised support through a series of calls to carers. These calls targeted reducing carers’ emotional burden and anxiety related to the treatment for their child, ultimately improving adherence to the prescribed r-hGH regimen.

Our study demonstrates the programme's positive impact across Argentina, South Korea, and Taiwan in enhancing carers' adherence behaviours related to their child's treatment. The study specifically examined the impact of the programme on knowledge, beliefs, and perceptions of adherence to r-hGH treatment among carers screened as ‘high-risk’ based on a personalisation screening questionnaire.

High-risk carers were determined as those who had low disease and treatment coherence, low treatment administration efficacy, high emotional burden, and high treatment-related anxiety.

What the research tells us

A prospective pre–post research design was used, with 409 carer participants across three countries (Argentina, South Korea, and Taiwan).

High-risk carers received up to five personalised calls from specially-trained nurse practitioners, who employed behaviour change techniques (BCTs) and motivational interviewing principles to address adherence barriers.

Carers were categorised as high-risk based on suboptimal scores in four key areas:

Disease & Treatment Coherence

Emotional Burden

Treatment-Related Anxiety

Self-Administration

The TUITEK® PSP, with its strong nurse-led support, resulted in statistically significant positive changes across all four key areas. This highlights the indispensable role of nurse practitioners in supporting carers and enhancing r-hGH treatment adherence.

The programme's personalised approach, utilising BCTs and motivational interviewing by expertly-trained nurse practitioners, proved effective in reducing emotional burden and treatment-related anxiety among carers. The programme's principles, particularly the nurse-led support, can be applied across different cultural and linguistic contexts, making it a valuable tool for healthcare providers and carers in managing GHD treatment.

"Addressing these factors, should, in turn, improve clinical outcomes"

Applying the research

We specialise in personalised, multichannel, nurse-led support for patients and carers across various long-term health conditions. Our programmes utilise behavioural science-based interventional approaches for optimal improvement in health outcomes and patient engagement.

Working with patients, pharma, healthcare, and life sciences organisations, we co-design and deliver personalised behaviour change solutions across multiple channels.

Read more about the results and outcomes our solutions can bring.