Endocrine Abstracts

Background:Long acting somatostatin analogues are an effective treatment for acromegaly but require administration by nurses.To improve patient convenience we have taken care into the community with endocrine specialist nurse education of practice nurses in administration of injections.

Methods:After an initial pilot study, a questionnaire was administered to patients receiving, and practice nurses administering, Somatuline Autogel(SA) n=10 and Sandostatin(LAR) n=27.

Response rate of nurses and patients in the SA group was 100% and for LAR-85% and 81% respectively.

Results: At least one episode of needle blockade occurred during injection by 71% of nurses giving LAR (n=53) and none of nurses giving SA. Nurses were aware of injection costs in both LAR and SA groups but had concerns regarding administering injections, 67% and 30% respectively. All nurses administering SA were happy giving injections, however, 12.5% of nurses administering LAR were anxious. Patients cost estimation of LAR ranged from £300-£1150 (mean=£737) and £6-£1000 for SA (mean=£478). There was no difference in patient concern regarding cost (LAR-41%, SA-30%). All nurses receiving endocrine specialist nurse tuition were happy, however, 25% of LAR group received information from other sources and found this inadequate. Most patients in both groups were happy with treatment (LAR-96%, SA-100%) however 50% on LAR and 40% on SA would change treatment if possible.

Conclusion: SA was well tolerated. In contrast, needle blockade highlighted a common complication and led to significant concern in both nurses and patients in the LAR group, however, the introduction of a larger needle reduced blockade markedly. Most nurses and patients had a reasonable idea of injection costs. Despite satisfaction with treatment, half of patients in both LAR and SA group would be prepared to change treatment. Endocrine specialist education and support was crucial in medical management of patients receiving LAR and SA in the community.