Endocrine Abstracts

Background: Acromegaly is a chronic disease which causes multiple impairments that negatively affect daily life. Telemedicine is proving to be useful in diagnosing and treating these disabling aspects, including psycho-physical comorbidities, which are difficult to investigate during conventional visits.

Aim of the study: To improve the management of acromegaly, both in cured and active disease, through the use of telemedicine technologies in addition to conventional visits, tailoring individual healthcare pathways.

Methods: We conducted a prospective study in patients with a diagnosis of acromegaly. We randomly assigned to participants a web-based email system (electronic Health Device group or ‘eHD group’). For 12 months, this group received periodic questionnaires that explored different areas such as adherence to therapy, quality of life, psychological and disease-specific symptoms (e.g. Acromegaly Quality of Life Questionnaire ‘AcroQoL’, Epworth Sleepiness Scale ‘ESS’, Beck-Depression-Inventory-II ‘BDI-II’). Additionally, all patients underwent conventional on-site clinical assessments. Data collected were stored on a dedicated portal and statistically analysed.

Results: We enrolled 60 acromegalic patients (50% in the eHD group and 50% controls), 50/60 completed the study. Females were 56% and mean age was 59.6 years. Sex distribution and age were comparable in the two groups. Patients in the eHD group actively answered questionnaires for a mean time of 4 months (range=2-11), with higher compliance for monthly and trimestral questionnaires as compared to weekly ones (adherence of 91%, 88%, and 64%, respectively). Periodical questionnaires in eHD group revealed that some patients experienced severe clinical deterioration, which required specialist consultation during the study (e.g. BDI-II results showed that two patients experienced severe depression and two patients suffered from obstructive sleep apnea according to ESS results). At baseline, 70% of the participants were on medical treatment for acromegaly (pegvisomant or somatostatin analogues) and 30% were on remission. At the end of the study, biochemical disease control improved in 20% of the eHD group vs 8% of controls (P=0.42). A worsening was observed in 8% of participants in the control group only (P=0.53) and disease was stable in the remaining patients. Data collected from the eHD group showed a high adherence to medical therapy for acromegaly (95%, both with pegvisomant and somatostatin analogues).

Conclusion: our preliminary data indicates that telemedicine may be used to monitor and manage symptoms, personalize follow-up, and promote treatment compliance, thereby improving the clinical management of acromegaly.