ECE2011 Poster Presentations Pituitary (111 abstracts)
Lost to follow-up in acromegaly, results of ACROSPECT observational study
B D Delemer 1 , C R Reines 2 , T B Brue 3 , C C Cortet Rudelli 5 , I R Raingeard 6 , Y R Reznik 7 , X P Parot 2 & O C Chabre 4
1CHU de Reims, Reims, France; 2Novartis Oncology, Rueil-Malmaison, France; 3Hopital de la Timone, Marseille, France; 3/24/20114Hopital Albert Michallon, La Tronche, France; 5Clinique Marc Linquette, Lille, France; 6Hopital Lapeyronie, Montpellier, France; 7Hopital Cote de Nacre, Caen, France.
Lost to follow-up (LTFU) is a frequent problem in chronic diseases not evaluated yet in acromegaly despite the long-term need of medical treatment and complications survey in this disease.
Objectives: Evaluation of the prevalence of LTFU patients in a multi-center cohort, characteristics of defaulters and description of their evolution after they have been searched and found.
Méthods: Observational multicentric (25 centers study). Each center was asked for the number of acromegalic patients followed up between 1997 and 2007 and for the number of the LTFU patients in the same period. Patients LTFU were defined as the ones who missed follow-up appointments in at least 2 years. These patients and their GP were recalled by phone and mail and asked about reasons to non-attendance. They were invited either to come to the former center for evaluation of acromegaly or to fill up a medical questionnaire.
Results: A total of 482 patients under 2252 were identified as LTFU, mean 21.4% of the cohort with a variation between the centers from 7.7 to 49%. At the last evaluation before LTFU, IGF1 was normal without treatment in 54%, normal with a medical treatment in 16% and not controlled in 30% of the patients. Recent news have been collected in 362 patients with 62 dead. Most frequent reason of non-attendance was follow-up by another physician in 69%. Pourcentage of patients with medical treatment decreased from 28 to 15%. Among the 87 patients who came back in the center, acromegaly was not controlled in 20% and the treatment had to be modified in 17%, lack of medical survey was observed in 16%.
Conclusion: In acromegaly LTFU concerns 21.4% of the patients. Treatments are stopped in these patients in half of the cases. When the patients are reevaluated 20% are not controlled. As acromegaly can now be controlled quality of follow-up is a real clinical challenge.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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