CC BY-NC-ND 4.0 · Avicenna J Med 2020; 10(04): 215-222
DOI: 10.4103/ajm.ajm_46_20
Original Article

Physician’ attitudes to growth hormone replacement therapy in adults following pituitary surgery: Results of an online survey

Aishah Ekhzaimy
Department of Medicine, Endocrinology Division, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
Salem A Beshyah
Department of Endocrinology, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates
Khaled M Al-Dahmani
Department of Medicine, United Arab Emirates University, United Arab Emirates
Division of Endocrinology, Tawam Hospital, Al Ain, United Arab Emirates
Mussa H AlMalki
Obesity, Endocrine and Metabolism Centre, King Fahad Medical City, Riyadh, Saudi Arabia
College of Medicine, King Fahad Medical City, King Saud bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
› Author Affiliations

Subject Editor: Financial support and sponsorship Nil.


Objective: The aim of this study was to evaluate physician attitudes and practices in the management of adult growth hormone deficiency (GHD) following pituitary surgery. Materials and Methods: An online questionnaire survey was sent to a sample group of physicians. Results: A total of 131 respondents provided usable responses. More than three quarters were senior physicians, with most practicing in tertiary care centers (73%). Four-fifths of the respondents see at least 1 to 5 patients with GHD following pituitary surgery per year. Seventy-four percent acknowledge the benefit in principle of growth hormone replacement therapy (GHRT) for patients with GHD after pituitary surgery. Most respondents (84%) would only consider GHRT for symptomatic patients. However, 16% stated that patients with GHD after pituitary surgery generally suffer from the side effects of GHRT. Forty-four percent said that the serum insulin-like growth factor-1 (IGF-1) level is the best screening test for assessing GHD after pituitary surgery but 57% of the respondents would use IGF-I levels, and 29% the insulin tolerance test (ITT), in patients with a documented deficiency in three pituitary axes. The main barriers to long-term GHRT use were that it requires injections (67%), and is costly with limited supply (61%). Other reasons not to use GHRT include an absence of GHD symptoms and apparent GHT ineffectiveness (44%), physician lack of familiarity with the medication (40%), and lack of adherence to available guidelines (38%). Conclusion: This survey addressed physician attitudes and practices in recognizing and treating GHD in adult’s post-pituitary surgery. Regional guidelines must be developed to help address/tackle these issues and assist physicians in understanding and treating this condition.

Publication History

Article published online:
04 August 2021

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