Patient Attitudes and Preferences Regarding Treatment: GH Therapy for Childhood Short Stature

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Abstract

This paper examines the role of parents’ attitudes and preferences regarding growth hormone therapy for childhood short stature. Four main questions are addressed. First, what are the demographic characteristics of families seeking medical advice for their child’s short stature? Second, what are parents’ attitudes towards short stature? Third, what are parents’ treatment preferences (i.e. what characteristics of growth treatments are important to parents)? Finally, how do the attitudes of parents affect physician decision making? Several studies are reviewed and data are presented to answer these questions.

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Diagnostic controversy: the diagnosis of childhood growth hormone deficiency revisited

R Rosenfeld (1995)

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HEALTH CARE POLICY:Outcomes Research: Measuring the End Results of Health Care

C M Clancy (1998)

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Ethical issues in growth hormone therapy.

M Siegler, L Cuttler, J Lantos (1989)

Pediatricians face clinical and ethical dilemmas about therapy to augment growth in short children who do not meet classic criteria for growth hormone (GH) deficiency. Biologic norms of health are unhelpful because of the uncertain relationship between stature, GH secretion, health, and disease. Instead, we suggest that GH therapy be evaluated from the perspective of cultural norms. We compare GH therapy for short normal children with currently accepted therapies for non--life-threatening pediatric conditions such as well-child care, cosmetic therapy, treatment of psychological problems, and invasive outpatient therapy for chronic conditions. Based on this analysis, we argue that the burdens of therapy, the uncertainty about long-term risks and benefits, the unclear therapeutic end point, and the implications for child health policy place routine GH therapy for children without documented deficiency of GH secretion outside current pediatric ethical norms. Such therapy is properly administered within a comprehensive clinical research protocol.

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Author and article information

Journal

Journal ID (publisher-id): HRE

Journal ID (nlm-ta): Horm Res Paediatr

Journal ID (doi): 10.1159/issn.1663-2818

Title: Hormone Research in Paediatrics

Publisher: S. Karger AG

ISBN: 978-3-8055-6898-2

ISBN: 978-3-318-00450-2

ISSN (Print): 1663-2818

ISSN (Electronic): 1663-2826

Publication date Subscription-year: 1999

Publication date (Print): June 1999

Publication date (Electronic): 17 November 2004

Volume: 51

Issue: Suppl 1

Pages: 67-72

Affiliations

^aDepartments of Pediatrics, ^bMarketing and ^cBanking and Finance, ^dEpidemiology and Biostatistics and ^ePharmacology, Case Western Reserve University, Cleveland, Ohio, USA

Article

Publisher ID: 53138 Other ID: Horm Res 1999;51(suppl 1):67–72

DOI: 10.1159/000053138

PubMed ID: 10393494

SO-VID: 7f71c3f1-fa29-49d9-bf39-6f615a632176

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Patient Attitudes and Preferences Regarding Treatment: GH Therapy for Childhood Short Stature

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Karger: Endocrinology

Most cited references 3

Diagnostic controversy: the diagnosis of childhood growth hormone deficiency revisited

HEALTH CARE POLICY:Outcomes Research: Measuring the End Results of Health Care

Ethical issues in growth hormone therapy.

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