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

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

Evidence for Change

Evidence for Change provides a quick, evidence-based overview of key behavioral 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 behavioral science and health psychology experts to bring the latest evidence-based interventional approaches in developing and building optimized 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 caregivers 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 Program was created to address these issues. The program uses behavioral science-based interventional techniques and was delivered by highly skilled and dedicated nurse practitioners who provided personalized support through a series of calls to caregivers. These calls targeted reducing caregivers’ emotional burden and anxiety related to the treatment for their child, ultimately improving adherence to the prescribed r-hGH regimen.

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

High-risk caregivers 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 caregiver participants across three countries (Argentina, South Korea, and Taiwan).

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

Caregivers were categorized 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 caregivers and enhancing r-hGH treatment adherence.

The program's personalized approach, utilizing BCTs and motivational interviewing by expertly-trained nurse practitioners, proved effective in reducing emotional burden and treatment-related anxiety among caregivers. The program'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 caregivers in managing GHD treatment.

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

Applying the research

We specialize in personalized, multichannel, nurse-led support for patients and caregivers across various long-term health conditions. Our programs utilize behavioral science-based interventional approaches for optimal improvement in health outcomes and patient engagement.

Working with patients, pharma, healthcare, and life sciences organizations, we co-design and deliver personalized behavior change solutions across multiple channels.

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