Endocrine Abstracts

GH deficiency in adults is associated with physical, psychological and quality of life impairment. A vast range of treatment options is available for GH and with the right device and adequate education and monitoring, patients report a significant improvement in their quality of life. A holistic approach should be adopted when deciding on a treatment regime for GH, which takes into consideration the patient’s physical/cognitive ability and their social environment. The Endocrine Nurse has a vital role in selecting the right treatment and monitoring patient’s progress. Biochemical parameters and quality of life questionnaires provide useful information, however, they should be combined with regular consultations, continuing education, and patient’s active involvement in their treatment to provide the best outcome.

At University College Hospital in London we have a caseload of 250 patients on GH. Following diagnosis of GH deficiency, patients are referred to the Endocrine Nurse for treatment initiation and long term monitoring based on an evidence based protocol. A detailed face to face initial consultation ensures that patients receive the right education and information about their treatment and long-term monitoring. Patients are then transferred to a Nurse-led telephone clinic for six monthly follow ups, although these do not replace their routine face to face pituitary clinic appointments. A recent audit showed that patients on GH monitored in the Nurse-led Clinic report better levels of satisfaction with and adherence to treatment as well as biochemical parameters compared to patients monitored in the community by their General Practitioner. This supports the need for patients on GH to be monitored in a Nurse-led Clinic, although the Endocrine Nurse should be aware of the risk of other team members being de-skilled and should organise regular educational sessions which will provide them with the up to date developments in this area.