Growth hormone delivery devices: current features and potential for enhanced treatment adherence.

INTRODUCTION: Adherence to daily growth hormone (GH) injections optimizes treatment benefit; however, adherence rates are sometimes poor. Reasons for poor adherence and persistence are multifaceted. GH injection devices are undergoing continual improvement to enhance adherence. Areas covered: This review evaluates published data on the evolution of GH injection devices to meet patients' needs and preferences, patients' perception of new devices and the projected impact of device developments on adherence. Published studies were identified through literature database searches including EMBASE and PubMed (January 1985-November 2015). Expert opinion: Patient needs and preferences trend towards convenient, easy-to-use devices that enable self-injection, minimize injection preparation steps by reducing the medication reconstitution and storage requirements, and reduce injection pain. In comparative studies, devices that patients considered easier to use than comparator devices were associated with reduced handling errors, fear of injection (needle anxiety/needle phobia) and pain upon needle insertion, and were thus preferred. A combination of the following items are expected to increase patient motivation to better adhere to therapy and improve treatment outcomes: advances in GH injection devices, educating patients regarding injection device and injection technique, and ongoing support from healthcare professionals, including comprehensive education about their condition, medication and expected outcomes.