Endocrine Abstracts (2019) 63 CET1 | DOI: 10.1530/endoabs.63.CET1

How can patients' perception of outcome be improved after controlling pituitary disease?

Prof Susan M Webb


Spain.


As endocrinologists, we consider a patient with a pituitary disease is controlled if hormone parameters are normalized and tumour growth is stabilized. However, the patients’ perception of health is related to whether they can continue performing their daily life, both personal and professional; this is often not the case due to pain, physical or psychological limitations or social/family issues related to their disease. This is more relevant nowadays that pituitary dysfunction can be controlled in most cases, either after surgery or with medical therapy. In the last 2 decades, the long-term impact of prior exposure to hypercortisolism, excess GH/IGF-I or hypopituitarism on patients’ health perceptions have become apparent. More cardiovascular, skeletal and neuropsychological morbidity persist after endocrine ‘cure’; the latter include worse memory, cognition, executive function, emotional coping, which often lead to more anxiety, depression and psychological distress, with an important impact on perceived quality of life. Patients’ perceptions may be overseen or ignored by health professionals, unless specifically mentioned; in this respect, the personal experiences of ‘cured’ patients, especially those in some way related to the health system or patient associations are very illustrative. It is recommendable to make patients aware of these problems, by devoted multidisciplinary teams with an understanding of these persistent issues, so they can adapt to these limitations.This understanding, together with a positive approach to day-to-day life, and comprehension and support from family and friends, contribute to accept this new situation, impacting positively on patients’ health perception and long-term prognosis.

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