Endocrinology Unit, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Pituitary. 2013 Jun;16(2):245-50. doi: 10.1007/s11102-012-0412-x.
Approximately 50 % of all acromegalic patients will require lifelong medical treatment to normalize mortality rates and reduce morbidity. Thus, adherence to therapy is essential to achieve treatment goals. To date, no study has evaluated the frequency and reasons for loss to follow-up in the acromegalic population. The current study aimed at evaluating the frequency of acromegalic patient loss to follow-up in three reference centers and the reasons responsible for their low compliance with treatment. All of the files for the acromegalic patients in the three centers were reviewed. Those patients, who had not followed up with the hospital for more than a year, were contacted via phone and/or mail and invited to participate. Patients who agreed to participate were interviewed, and blood samples were collected. A total of 239 files were reviewed; from these 42 patients (17.6 %) were identified who were lost to follow-up. It was possible to contact 27 of these patients, 10 of whom did not attend the appointments for more than one time and 17 of whom agreed to participate in the study. Fifteen of these 17 patients had active disease (88.2 %), and all of the patients restarted treatment in the original centers. The main reason for loss to follow-up was an absence of symptoms. High-quality follow-up is important in acromegaly to successfully achieve the aims of the treatment. An active search for patients may allow the resumption of treatment in a significant proportion of these cases, contributing to reduced morbidity and mortality in this patient population.
大约 50%的肢端肥大症患者需要终身接受医学治疗，以使死亡率正常化并降低发病率。因此，坚持治疗对于实现治疗目标至关重要。迄今为止，尚无研究评估肢端肥大症患者失访的频率及其不遵医嘱的原因。本研究旨在评估三个参考中心肢端肥大症患者失访的频率，以及导致其治疗依从性差的原因。对三个中心的所有肢端肥大症患者的档案进行了审查。那些超过一年未到医院随访的患者通过电话和/或邮件联系，并邀请他们参加。同意参加的患者接受了访谈，并采集了血样。共审查了 239 份档案，其中 42 名（17.6%）患者失访。对其中 27 名患者进行了联系，其中 10 名患者多次未就诊，17 名患者同意参加研究。这 17 名患者中有 15 名（88.2%）仍处于活跃疾病状态，所有患者均在原中心重新开始治疗。失访的主要原因是无症状。高质量的随访对于肢端肥大症的成功治疗至关重要。积极寻找患者可能会使很大一部分患者重新开始治疗，从而降低该患者人群的发病率和死亡率。
