Endocrine Abstracts

Objective: The aim of this study conducted in a German University Hospital was to systematically assess health care utilisation and delivery in patients with acromegaly and to thus identify possible starting points for the improvement of patient care.

Design/Methods: By means of a standardized anamnestic interview, 41 patients with biochemically proven acromegaly were questioned on the course of their disease. To investigate patient care the interview included questions on the time lapse of symptom onset, first seeking medical advice and time of diagnosis of acromegaly as well as questions on the medical speciality of the diagnosing doctor and other diagnoses made before. Patients were also asked to recall which symptoms they had noted first and to account which symptoms were still persisting.

Results: Time lapse between first symptoms and diagnosis was on average 3.8 years. 1.76 years elapsed while patients waited to see the doctor, a lapse of 2.05 years was due to delay in the diagnostic process. Among the most frequently mentioned symptoms experienced by the patients were teeth and jaw problems. 36.6% of the patients reported to have visited the dentist more than usual at any time during the disease. 9.8% even remembered this to be one of the first symptoms they experienced, 22% reported these symptoms to still persist. Nevertheless, none of the patients was diagnosed with acromegaly by a dentist. Most diagnoses were made by internists, neurologists, orthopedists or the family doctor.

Conclusion: Diagnostic delay is still considerable in patients with acromegaly. In part, this might be due to the fact, that although many patients with acromegaly visit dentists, the disease seems to be widely unknown to these. One starting point for the improvement of patient care might, therefore, be a better information on acromegaly for dentists.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.