Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy.
COR2ED, Bottmingen, Switzerland.
Endocrine. 2021 Feb;71(2):273-280. doi: 10.1007/s12020-020-02565-1. Epub 2021 Jan 7.
With most global healthcare resources focused on COVID-19, altered resource allocation is disrupting the continuum of care for chronic endocrine conditions, including acromegaly. In order to assess the effects of COVID-19 on care of patients with acromegaly, we conducted an international online survey of endocrinologists. The questionnaire was drafted by a Steering Committee of acromegaly experts and covered both respondent demographics, contact and communication with patients, and patient care. Respondent awareness was generated through social media campaigns and the survey completed online using Google forms. The majority of endocrinologists who responded (N = 84) were based in Europe (67.9%) and were female (58.3%). Slightly more than half of respondents worked in a specialized pituitary center (52.4%) and a large minority cared for more than 50 acromegaly patients (47.6%). Most respondents (85.7%) indicated surgery was their first-line treatment, with only 14.3% indicating medical therapy as a first-choice treatment option. One-third (33.3%) of respondents reported having delayed a planned surgery due to a lack of COVID-19 testing provision and 54.8% due to a lack of surgical provision; 19.1% indicated that a lack of personal protective equipment had reduced their ability to treat patients with acromegaly. Just 21.4% of respondents reported no negative effects from the pandemic on diagnostic practice patterns, and just 19.1% reported no negative effect on patient follow-up practices. Many respondents (55.9%) indicated that remote methods had improved their ability to communicate with their patients and 69.0% indicated that they would continue to use methods of consultation necessitated by the COVID-19 pandemic. Our data suggest the COVID-19 pandemic is substantially affecting the care of acromegaly. However, these results also suggest that endocrinologists are embracing aspects of the 'new normal' to create a novel continuum of care better suited to the presumed post-COVID-19 environment. The goal of these changes must be both to improve care while shielding patients from more severe involvement in concomitant acute illnesses such COVID-19.
由于大多数全球医疗资源都集中在 COVID-19 上，资源配置的改变打乱了慢性内分泌疾病（包括肢端肥大症）的连续护理。为了评估 COVID-19 对肢端肥大症患者护理的影响，我们对内分泌学家进行了一项国际在线调查。问卷由肢端肥大症专家指导委员会起草，涵盖了受访者的人口统计学信息、与患者的联系和沟通以及患者护理情况。通过社交媒体活动和使用 Google 表单在线完成的调查来提高受访者的意识。做出回应的大多数内分泌学家（N=84）都来自欧洲（67.9%），且为女性（58.3%）。略多于一半的受访者在专门的垂体中心工作（52.4%），极少数人治疗的肢端肥大症患者超过 50 人（47.6%）。大多数受访者（85.7%）表示手术是他们的一线治疗方法，只有 14.3%表示药物治疗是首选治疗方案。三分之一（33.3%）的受访者报告因缺乏 COVID-19 检测供应而延迟了计划中的手术，54.8%是因为缺乏手术供应；19.1%表示缺乏个人防护设备降低了他们治疗肢端肥大症患者的能力。只有 21.4%的受访者报告大流行对诊断实践模式没有负面影响，只有 19.1%报告对患者随访实践没有负面影响。许多受访者（55.9%）表示远程方法提高了他们与患者沟通的能力，69.0%表示他们将继续使用 COVID-19 大流行所必需的咨询方法。我们的数据表明，COVID-19 大流行正在严重影响肢端肥大症的护理。然而，这些结果也表明，内分泌学家正在接受“新常态”的某些方面，以创建更适合假定的 COVID-19 后环境的新型连续护理。这些变化的目标必须是在保护患者免受更严重的急性疾病（如 COVID-19）合并症的同时，改善护理。
