The use of a specific questionnaire to assess quality of life in growth hormone deficient adults
M Sathiavageeswaran1, K Bisp2 & JAH Wass3
The use of a specific questionnaire to assess quality of life(QoL) in adults with growth hormone deficiency (GHD) and its improvement after treatment requires further studies, in particular, their relationship to basal scores and Insulin like growth factor (IGF-1) values. We analysed our data to determine if the QoL as assessed by the QoL-AGHDA improved in adult GHD patients following growth hormone (GH) replacement.
Patients referred with symptoms of GHD were entered into the database. At the first visit, baseline IGF-1 level was determined and the QoL-AGHDA questionnaire was administered. IGF-1 level and the QoL-AGHDA were repeated at an annual follow up visit. Values are expressed as mean plus/minus s.e.m.
191 patients were started on GH between January 1998 and October 2002. Data are presented on 130 patients (67 female) who have completed at least one year of the trial. 36 (28 percent) patients had a baseline IGF-1 level of less than minus 2 sd from mean. Following a years' replacement with GH there was a significant increase in the IGF-1 (177.82 plus/minus 113.32 nanogram per litre v 269.03 plus/minus 116.81 nanogram per litre, p=0.002) and in Qol-AGHDA scores (14.32 plus/minus 6.33 v 9.04 plus/minus 6.34 p=0.0001). 71 percent of patients with an AGHDA score of 16 to 25, 60percent with a score between 10 and 15 and 25percent of patients with a score less than 9 showed an improvement in their score by 4 or more points following treatment. 46.4percent of patients with a score less than 9 at baseline had a worse score following GH treatment.
The Qol-AGHDA questionnaire is a useful instrument to measure QoL in patients with GHD. Patients with a score at baseline of 10 to 25 have a 60percent chance of their score improving by 4 or more points in a year following GH replacement. An AGHDA score of 10 is a useful cut-off for predicting improvement in QoL.