Adherence remains a challenge for patients receiving growth hormone therapy.

Patients receiving growth hormone therapy have the best growth results when they have good adherence, but adherence rates are often low. Adherence has been difficult to measure and is often measured indirectly as direct methods are inconvenient, expensive or both. However, use of electronic monitors that log the dose and the time it was delivered provides a simple and reliable means of gathering data and may facilitate the discussion of adherence in the clinic. Although many factors impact on adherence, there are some 'red flags' to which a physician should be particularly alert, such as history of poor attendance at consultations. Based on the author's own clinical experience and opinion, as well as published studies, this article describes factors associated with non-adherence and how most, if not all, barriers to good adherence can be overcome by maintaining a good non-judgemental relationship with the patient, and delivering useful and clear education and training soon after diagnosis.