Exploring potential influencing factors of inadherence to specialist aftercare and long-term medication in patients with acromegaly.

IF 3.3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM Pituitary Pub Date : 2024-08-01 Epub Date: 2024-05-24 DOI:10.1007/s11102-024-01400-4

Sonja Siegel, Sabrina Giese, Jürgen Honegger, Anna Lena Friedel, Agnieszka Grzywotz, Karsten Henning Wrede, Ulrich Sure, Nicole Unger, Ilonka Kreitschmann-Andermahr

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Abstract

Purpose: To improve the understanding of adherence as one major factor of disease control in acromegaly patients, we systematically assessed patients' motivations to adhere to advised follow-up schedules and recommended medication for acromegaly.

Methods: Cross-sectional, postal questionnaire study on adult patients with acromegaly, operated upon a growth hormone producing pituitary adenoma more than 1 year ago in two tertiary treatment centers. We assessed demographic and clinical characteristics, disease status, adherence to acromegaly medication and/or aftercare, and the five dimensions defined by the World Health Organization influencing adherence. Wherever applicable, we included validated short scales. The answers of 63 patients (33 f, 30 m; mean age 56.1 y) were analyzed.

Results: Patients with problems in adherence to aftercare had a significantly lower subjective symptomload than those adherent to aftercare (p = 0.026) and a lower perceived need for treatment (p = 0.045). Patients with adherence problems to medication had a higher subjective symptomload than those without (p = 0.056). They also tended to have shorter consultations, were significantly more often dissatisfied with the duration of their medical consultations (42% vs 4.8%, p = 0.019) and tended to find that their physician explained potential difficulties with adherence less well than patients without adherence problems (p = 0.089).

Conclusions: To our knowledge, this is the first study which explored adherence to medication and aftercare in patients with acromegaly, taking into account potential influencing factors from all areas defined by the WHO model of adherence. Of the modifiable factors of adherence, patient-doctor relationship seemed to play a crucial role and could be one leverage point to improve adherence.

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探索肢端肥大症患者不坚持专科术后护理和长期服药的潜在影响因素。

目的：为了更好地了解肢端肥大症患者坚持治疗是疾病控制的一个主要因素，我们系统地评估了患者坚持建议的随访时间和推荐的肢端肥大症药物治疗的动机：方法：横断面邮寄问卷调查，对象是在两家三级治疗中心接受生长激素垂体腺瘤手术超过一年的成年肢端肥大症患者。我们评估了人口统计学和临床特征、疾病状态、对肢端肥大症药物治疗和/或术后护理的依从性，以及世界卫生组织定义的影响依从性的五个方面。在适用的情况下，我们采用了经过验证的简易量表。我们对 63 名患者（33 名女性，30 名男性；平均年龄 56.1 岁）的回答进行了分析：结果：在坚持术后护理方面存在问题的患者，其主观症状负荷明显低于坚持术后护理的患者（p = 0.026），其治疗需求感知也明显低于坚持术后护理的患者（p = 0.045）。有服药问题的患者的主观症状负荷高于无服药问题的患者（p = 0.056）。他们的就诊时间往往更短，对就诊时间的不满意度明显更高（42% vs 4.8%，p = 0.019），而且他们往往认为医生对他们在坚持用药方面可能遇到的困难的解释不如没有坚持用药问题的患者（p = 0.089）：据我们所知，这是第一项探讨肢端肥大症患者服药依从性和术后护理的研究，其中考虑到了世界卫生组织依从性模型所定义的所有领域的潜在影响因素。在可改变依从性的因素中，患者与医生的关系似乎起着至关重要的作用，可以成为提高依从性的一个杠杆点。

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来源期刊

Pituitary 医学-内分泌学与代谢

CiteScore

7.10

自引率

7.90%

发文量

审稿时长

6 months

期刊介绍： Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.

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