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In particular, prescription medications may not achieve the positive outcomes expected because approximately half of patients adhere poorly to the prescribed treatment regimen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Adherence to treatment has previously been assessed using relatively unreliable subjective methods, such as patient self-reporting during clinical follow-up, or counting prescriptions filled or vials returned by patients. Here, we report on a new approach, the use of electronically recorded objective evidence of date, time, and dose taken which was obtained through a comprehensive eHealth ecosystem, based around the easypod\u2122 electromechanical auto-injection device and web-based connect software. The benefits of this eHealth approach are also illustrated here by two case studies, selected from the Finnish cohort of the easypod\u2122 Connect Observational Study (ECOS), a 5-year, open-label, observational study that enrolled children from 24 countries who were being treated with growth hormone (GH) via the auto-injection device.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Analyses of data from 9314 records from the easypod\u2122 connect database showed that, at each time point studied, a significantly greater proportion of female patients had high adherence (\u2265\u200985%) than male patients (2849\/3867 [74%] vs 3879\/5447 [71%]; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Furthermore, more of the younger patients (&lt;\u200910\u00a0years for girls,\u2009&lt;\u200912\u00a0years for boys) were in the high adherence range (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). However, recursive partitioning of data from ECOS identified subgroups with lower adherence to GH treatment \u2012 children who performed the majority of injections themselves at an early age (~\u20098\u00a0years) and teenagers starting treatment aged\u2009\u2265\u200914\u00a0years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The data and case studies presented herein illustrate the importance of adherence to GH therapy and how good growth outcomes can be achieved by following treatment as described. They also show how the device, software, and database ecosystem can complement normal clinical follow-up by providing HCPs with reliable information about patient adherence between visits and also providing researchers with real-world evidence of adherence and growth outcomes across a large population of patients with growth disorders treated with GH via the easypod\u2122 device.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-021-01491-0","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T10:06:17Z","timestamp":1619431577000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Connected health for growth hormone treatment research and clinical practice: learnings from different sources of real-world evidence (RWE)\u2014large electronically collected datasets, surveillance studies and individual patients\u2019 cases"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7613-3297","authenticated-orcid":false,"given":"Nea","family":"Boman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8165-9904","authenticated-orcid":false,"given":"Luis","family":"Fernandez-Luque","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2572-9052","authenticated-orcid":false,"given":"Ekaterina","family":"Koledova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marketta","family":"Kause","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8030-2505","authenticated-orcid":false,"given":"Risto","family":"Lapatto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"key":"1491_CR1","unstructured":"Sabat\u00e9 E. 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Written informed consent was obtained from patients (or their parent\/guardian) prior to study enrolment. In order to allow statistical analysis of patient data, patients sign a user agreement before enrolling on easypod\u2122 connect.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication was obtained from either the patients or their parents\/caregivers.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"NB and RL have no conflict of interest to report. LFL is General Manager of Salumedia Labs, a fully owned subsidiary of Adhera Health Inc. that is a precision digital therapeutics company based in Palo Alto (CA, USA). Salumedia Labs provides digital health services to the pharmaceutical industry, including Merck KGaA (Darmstadt, Germany). LFL is a shareholder of Adhera Health Inc. EK is an employee of Merck KGaA, Darmstadt, Germany. MK is an employee of Merck Oy Finland, Espoo, Finland (an affiliate of Merck KGaA, Darmstadt, Germany).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"136"}}