Endocrine Abstracts

Primary hyperparathyroidism (PHPT) is a complex endoctinopathy that involves parathyroid glands which secreting too much parathyroid hormone and due to causes hypercalcemia effecting different organs and leading to significant quality of life (QoL) impairment. QoL assessment before and after surgery in patients with PHTP may be useful for comprehensive evaluation of the treatment effect, as well as for monitoring of the patient’ condition after surgery, including in real clinical practice. The aim of the study was to evaluate changes in QoL of PHPT patients after parathyroidectomy (PTX) and to test applicability of the disease-specific QoL questionnaire – PHPQoL for its further implementing in clinical practice and research in this patients group. The PHPQoL includes 16 items; the total PHPQoL score is standardized from 0 (worst QoL) to 100 (best QoL). The linguistic and cultural adaptation of the PHPQoL questionnaire was carried out in accordance with international guidelines. Adult patients with PHPT who were referred to PTX filled out the PHPQoL twice: before and 3 mos after PTX. Psychometric properties of PHPQoL were tested – its reliability, validity and sensitivity. Statistical analysis of QoL data included assessment of Spearman correlations and Student’s paired test. In the whole, 65 patients with PHPT were involved into the study (mean age – 52.3 ± 10.5 years, 97% – women): 67.7% patients were symptomatic, 35.4% patients had moderate or severe hypercalcemia. Satisfactory external and content validity of the PHPQoL were demonstrated; the tool was easy to understand and informative to capture specific concerns of PHPT patients. Reliability of PHPQoL was confirmed by the high Cronbach’s alpha coefficient (α = 0.87). Clinical validity of PHPQoL was shown: symptomatic patients had worse QoL than asymptomatic (PHPQoL total score 47.4 vs 64.7, P = 0.01); the more symptoms of PHPT the worse QoL (r = –0.46; P < 0.001). The positive effect of the surgery on QoL in PHPT patients was demonstrated: PHPQoL total score before PTX 46.7 vs 55.7 after PTX (P < 0.05), these results may testify sensitivity of the tool. Clinically meaningful QoL increase (MID for PHPQoL total score ≥ 9 points) was demonstrated in 44% patients after PTX; PHPQoL total score range 51–100 was revealed in 76% patients after surgery. PTX leads to noticeable QoL improvement in PHPT patients. PHPQoL is a feasible and practical PHPT specific tool with satisfactory reliability, validity and sensitivity for QoL assessment in PHPT patients undergoing surgery.