{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T01:49:04Z","timestamp":1784166544977,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014756","name":"Hexal AG","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014756","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Little is known about psychological reasons associated with adherence to growth hormone (GH) replacement therapy (GHRx) in adults. As in other chronic diseases, medication-related beliefs, coping strategies and disease impact on quality of life (QoL) might play an important role. We thus explored these psychological factors in relation to adherence in patients with GH deficiency (GHD) in order to find leverage points for the improvement of adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Cross-sectional\u00a0analysis including 107 adult GHD patients on GHRx who completed self-assessment inventories on health-related QoL (Short-Form SF-36), coping style (Freiburg questionnaire on coping with illness, FKV-LIS) and medication beliefs (Beliefs about Medicine questionnaire, BMQ). Results were correlated to general and GH-specific adherence to medication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the BMQ, 92.5% of the patients (n=99) reported a strong belief in the need for their medication, which correlated significantly with general adherence (r<jats:sub>s<\/jats:sub> = 0.325).\u00a0Active coping was significantly related to general (r<jats:sub>s<\/jats:sub> = 0.307) and GH-specific adherence (r<jats:sub>s<\/jats:sub> = 0.226). Better mental QoL (r<jats:sub>s<\/jats:sub> = 0.210) but worse physical QoL (r<jats:sub>s<\/jats:sub> = -0.198; all p &amp;lt; 0.05) were related to higher GH-specific adherence. Older age was associated with a higher degree of active coping, a\u00a0higher belief in the necessity of medication and worse physical QoL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We provide preliminary data that most GHD patients on GHRx are strongly convinced of their need for\u00a0medication and that adherence to GHRx is influenced by coping strategies and QoL. Patients with impaired psychological QoL are less able to translate their convictions into good adherence, a phenomenon to be addressed in future research.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.680964","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T06:47:23Z","timestamp":1621838843000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Adults\u2019 Adherence to Growth Hormone Replacement in Relation to Medication-Related Beliefs, Coping and Quality of Life - An Exploratory Analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Sonja","family":"Siegel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Unger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Streetz-van der Werf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram","family":"Karges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Schilbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette","family":"Schr\u00f6der","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Szybowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janina","family":"Sauerwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Zopf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Grzywotz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bidlingmaier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric","family":"Kirstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heide","family":"Sommer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J.","family":"Strasburger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilonka","family":"Kreitschmann-Andermahr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1817346","article-title":"Pathogenesis and Diagnosis of Growth Hormone Deficiency in Adults","volume":"380","author":"Melmed","year":"2019","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1159\/000184756","article-title":"Growth Hormone Deficiency and Quality of Life","volume":"45","author":"McGauley","year":"1996","journal-title":"Horm Res"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-2415","article-title":"Update in Mortality in GH-Treated Patients","volume":"98","author":"Erfurth","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030840","article-title":"Impact of Growth Hormone (GH) Treatment on Cardiovascular Risk Factors in GH-Deficient Adults: A Metaanalysis of Blinded, Randomized, Placebo-Controlled Trials","volume":"89","author":"Maison","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000169","article-title":"Quality of Life in Patients With Hypopituitarism","volume":"22","author":"Crespo","year":"2015","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2892","article-title":"Ten-Year Change in Quality of Life in Adults on Growth Hormone Replacement for Growth Hormone Deficiency: An Analysis of the Hypopituitary Control and Complications Study","volume":"99","author":"Mo","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"B7","volume-title":"Adherence to Long-Term Therapies: Evidence for Action","year":"2003"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1159\/000493211","article-title":"Identifying Potentially Modifiable Factors Associated With Treatment Non-Adherence in Paediatric Growth Hormone Deficiency: A Systematic Review","volume":"90","author":"Graham","year":"2018","journal-title":"Horm Res Paediatr"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1055\/a-0956-1919","article-title":"Adherence, Attitudes and Beliefs of Growth Hormone Deficient Patients - a Questionnaire-Based Cohort Study","volume":"129","author":"Amereller","year":"2021","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-020-01046-y","article-title":"Motivation for and Adherence to Growth Hormone Replacement Therapy in Adults With Hypopituitarism: The Patients\u2019 Perspective","volume":"23","author":"Kreitschmann-Andermahr","year":"2020","journal-title":"Pituitary"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1546682","article-title":"Targeted Literature Review of the Humanistic and Economic Burden of Adult Growth Hormone Deficiency","volume":"35","author":"Loftus","year":"2019","journal-title":"Curr Med Res Opin"},{"key":"B12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1080\/13548509608400007","article-title":"Coping, Social Support and Chronic Disease: A Research Agenda","volume":"1","author":"Ridder","year":"1996","journal-title":"Psychol Health Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1037\/0022-006X.63.3.454","article-title":"Coping With Treatment-Related Stress: Effects on Patient Adherence in Hemodialysis","volume":"63","author":"Christensen","year":"1995","journal-title":"J Consult Clin Psychol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2012.03.018","article-title":"Associations Between Coping, Diabetes Knowledge, Medication Adherence and Self-Care Behaviors in Adults With Type 2 Diabetes","volume":"34","author":"Smalls","year":"2012","journal-title":"Gen Hosp Psychiatry"},{"key":"B15","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1037\/0882-7974.2.2.164","article-title":"Age Differences in Coping With Chronic Illness","volume":"2","author":"Felton","year":"1987","journal-title":"Psychol Aging"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(99)00058-6","article-title":"Patients\u2019 Beliefs About Treatment: The Hidden Determinant of Treatment Outcome","volume":"47","author":"Horne","year":"1999","journal-title":"J Psychosom Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(99)00057-4","article-title":"Patients\u2019 Beliefs About Prescribed Medicines and Their Role in Adherence to Treatment in Chronic Physical Illness","volume":"47","author":"Horne","year":"1999","journal-title":"J Psychosom Res"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318032937e","article-title":"Health Beliefs, Disease Severity, and Patient Adherence: A Meta-Analysis","volume":"45","author":"DiMatteo","year":"2007","journal-title":"Med Care"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1023\/A:1025180524614","article-title":"Is Adherence to Drug Treatment Correlated With Health-Related Quality of Life","volume":"12","author":"C\u00f4t\u00e9","year":"2003","journal-title":"Qual Life Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afq040","article-title":"Health-Related Quality of Life and Antihypertensive Medication Adherence Among Older Adults","volume":"39","author":"Holt","year":"2010","journal-title":"Age Ageing"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.31311","article-title":"Relationship of Health-Related Quality of Life to Treatment Adherence and Sustained Response in Chronic Hepatitis C Patients","volume":"35","author":"Bernstein","year":"2002","journal-title":"Hepatology"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.2.8216","article-title":"Which Patients Do Not Require a GH Stimulation Test for the Diagnosis of Adult GH Deficiency","volume":"87","author":"Hartman","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"B23","article-title":"Freiburger Fragebogen Zur Krankheitsverarbeitung","volume-title":"Fkv","author":"Muthny","year":"1989"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/08870449908407311","article-title":"The Beliefs About Medicines Questionnaire: The Development and Evaluation of a New Method for Assessing the Cognitive Representation of Medication","volume":"14","author":"Horne","year":"1999","journal-title":"Psychol Health"},{"key":"B25","volume-title":"Subjektive Krankheits- Und Behandlungskonzepte Bei Patientinnen Mit Fibromyalgiesyndrom","author":"Opitz","year":"2011"},{"key":"B26","first-page":"XVII","article-title":"Erfassung der gesundheitsbezogenen Lebensqualit\u00e4t mit dem SF-36 Health Survey [Assessment Of Health Related Quality Of Life With The SF-36 Health Survey]","volume":"35","author":"Bullinger","year":"1996","journal-title":"Rehabilitation (Stuttg)"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1998.00634.x","article-title":"One-Year Follow-Up of Quality of Life in Adults With Untreated Growth Hormone Deficiency","volume":"49","author":"Badia","year":"1998","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B28","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1046\/j.1365-2265.2003.01799.x","article-title":"Assessment of Quality of Life in Adults Receiving Long-Term Growth Hormone Replacement Compared to Control Subjects","volume":"59","author":"Malik","year":"2003","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B29","doi-asserted-by":"publisher","first-page":"4709645","DOI":"10.1155\/2019\/4709645","article-title":"Medication Adherence and Coping Strategies in Patients With Rheumatoid Arthritis: A Cross-Sectional Study","volume":"2019","author":"Berner","year":"2019","journal-title":"Int J Rheumatol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1037\/a0040388","article-title":"Psychosocial Factors in Medication Adherence and Diabetes Self-Management: Implications for Research and Practice","volume":"71","author":"Gonzalez","year":"2016","journal-title":"Am Psychol"},{"key":"B31","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511544293.018","article-title":"Depression and Adherence to Medical Advice","volume-title":"Depression and Physical Illness","author":"Raynor","year":"2006"},{"key":"B32","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The Theory of Planned Behavior","volume":"50","author":"Ajzen","year":"1991","journal-title":"Organ Behav Hum Decis Process"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e0238457","DOI":"10.1371\/journal.pone.0238457","article-title":"Metacognitive Beliefs and Their Relationship With Anxiety and Depression in Physical Illnesses: A Systematic Review","volume":"15","author":"Capobianco","year":"2020","journal-title":"PloS One"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2010.542815","article-title":"Depression and Medication Adherence Among Breast Cancer Survivors: Bridging the Gap With the Theory of Planned Behaviour","volume":"26","author":"Manning","year":"2011","journal-title":"Psychol Health"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.680964\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T06:47:26Z","timestamp":1621838846000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.680964\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,24]]},"references-count":34,"alternative-id":["10.3389\/fendo.2021.680964"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2021.680964","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,24]]},"article-number":"680964"}}