Endocrine Abstracts

Background: Acromegaly has until now been managed almost entirely in tertiary care. Introduction of nurses specialising in endocrinology has enabled us to take their care into the community.

Method: 39 patients (P) mean age 57y(29-82) with active acromegaly, required Octreotide LAR treatment, and lived 5-173(median 38) miles from the endocrine unit. A shared care (SC) protocol was approved whereby the patient's first injection was given at the hospital, the second at the GP surgery, where the hospital specialist nurse trained the practice nurses. Costs of SC were compared with a hospital-based model (H) at 6 months (m) (39 P) and 12 m (34 P). Costs were compared using AA data for travel, and hospital attendance, practice nurse administration of injection, endocrine nurse visit to community and hospital transport (4 P) were ascertained.

Results: Costs at 6m for SC were £18,073.32 and £45,378 for H and at 12m £17,835.92 (SC) and £79,176 (H). Travel costs to local GP were £335.93 at 6m and £1,639.88 at 12m and £7,256.82 at 6 m and £12,589.20 (H) at 12m. Overall costs at 6 m were £20,494.33 (SC) and £51,969.18 (H).

Conclusion: A shared care model brings significant savings to both the health service and to patients.