Managing Paediatric Growth Disorders: Integrating Technology Into a Personalised Approach

What is already known on this topic? There have been few articles specifically linking the human component of growth management, i.e. specialist and nurse interaction with the patient, psychological support and training of healthcare professionals in motivational interviewing together with digital innovations such as electronic monitoring of growth hormone (GH) injections. Both the human and digital components are recognised to contribute to GH adherence, but it is the necessity of their partnership that we emphasize. What this study adds? A review on the holistic approach to personalised growth management by multi-disciplinary professionals, but stressing the key importance of the human and technical partnership. Contributions are also provided by a professional coach who is an expert in motivational interviewing and personnel from the UK patient support group, the Child Growth Foundation. Long-term growth management can be challenging for patients, families and healthcare professionals (HCP). Personalised optimal responses to growth hormone (GH) therapy depend on the creation of a good working relationship between the patient and family and the HCPs responsible for care. Current unmet needs in growth management will be discussed, focusing on the likelihood of a poor growth response and its identification and management with emphasis on the importance of good adherence to GH therapy. Digital tools are now available to record injections and communicate accurate adherence data to the HCP and patient. Psychological barriers to good adherence will be covered, with techniques identified to change behaviour and improve outcome. Motivational interviewing is a valuable skill in this respect and should be taught to both medical and nursing HCPs to enhance the quality of the relationship with the patient and family. Key messages are, firstly, the importance of personalised care with the HCP using acquired psychological skills to prevent and manage poor adherence. Secondly, a human-eHealth partnership is necessary to maximise the benefit of new digital tools to aid in successful growth management. Keywords: Growth, growth hormone, adherence, motivational interviewing, eHealth