Endocrine Abstracts

Background: In acromegalic patients, quality of life reduction and neuropsychological impairment are common, in addition to well-known complications related to the pituitary adenoma and to the GH/IGF-I excess. Acromegalic patients need a lot of outpatient visits and a multidisciplinary approach during the management of the disease and its comorbidities. Aim of the project is to analyze the role of an electronic health device (eHD) with remote monitoring in management of acromegalic patients.

Materials and methods: In agreement with Philips, Pfizer and the Department of Management Engineering of the Politecnico of Milan, we provided an eHD, running a web application (Motiva by Philips) to 30 acromegalic patients in regular follow-up at our Institution, for a pilot project of 6 months. The project asked to every patients to periodically fulfill a series of questionnaires investigating compliance to medical therapy (daily or monthly depending on therapy), neuropsychological settings (every three months), quality of life (QoL, monthly) and disease specific symptoms (weekly).

Results: 30 patients (13 Male, mean age 56.9±13.2) received the tablet, 7 (23%) patients were in remission, 14 (47%) in treatment with somatostatin analogue and 9 (30%) with pegvisomant. Two patients abandoned the project for concomitant medical problems. Up to now, we are able to report preliminary data on the acceptance and use of the device and on adherence to the therapy, waiting for the end of the project in all patients. Three months after the start, data showed a high response rate to questionnaires (74%), especially to the disease-specific one. Adherence to therapy was 97.3%; in particular, only 4 patients (12%) declared they forgot or refused the therapy in more than one occasion. Patients demonstrated good adherence to the program, quickly reporting problems in the use of the device. At the end of the study, compliance improved to 98%. Five patients (17%) reported a better compliance to therapy, confirmed by an improved biochemical control.

Conclusions: Telemedicine may be a support for comprehensive management and follow-up of chronic patients. Our data showed that an eHD could be useful in the management of acromegalic patients, improving compliance to therapy. Moreover, these devices allow us to study aspects of difficult examination with regular outpatient visits, such as neuropsychological comorbidities or QoL.