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ORIGINAL ARTICLE
Year : 2020  |  Volume : 10  |  Issue : 4  |  Page : 215-222

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


1 Department of Medicine, Endocrinology Division, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
2 Department of Endocrinology, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates, Riyadh, Saudi Arabia; Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates, Riyadh, Saudi Arabia
3 Department of Medicine, United Arab Emirates University, United Arab Emirates, Riyadh, Saudi Arabia; Division of Endocrinology, Tawam Hospital, Al Ain, United Arab Emirates, Riyadh, Saudi Arabia
4 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

Correspondence Address:
Mussa H AlMalki
Obesity, Endocrine and Meta‑bolism Centre, King Fahad Medical City, Riyadh.
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajm.ajm_46_20

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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.


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