IS QUALITY OF LIFE RESTORED WITH MEDICATION IN PATIENTS WITH PITUITARY DEFICITS ?

2.50
Hdl Handle:
http://hdl.handle.net/10755/211524
Type:
Research Study
Title:
IS QUALITY OF LIFE RESTORED WITH MEDICATION IN PATIENTS WITH PITUITARY DEFICITS ?
Abstract:
Background: The pituitary is considered the ‘ master gland’ for its role in  directing  multiple broad functions including:  gonadal and reproduction functions, metabolic functions , somatic growth,  stress response and more  specific functions in water and electrolyte balance, blood pressure control, glucose control, weight management, sleep and mood control and more. Disturbances in one or more of these functions affect the individual’s life quality (QoL) to degrees that vary according to such factors as age, gender, culture and the meaning of the impact of the deficiency to the individual. Pituitary deficiencies usually occur from congenital pituitary damage, from injury (direct or indirect), inflammation or from the impact of a pituitary tumor.  Representing 15% of all brain tumors, pituitary tumors affect up to 27% of the population.  Estimates vary, but pituitary dysfunction has been reported in: 1: 8,000 people worldwide; 1: 5 patients after brain injury; 45:100 patients after subarachnoid hemorrhage: 2:3 patients with a symptomatic pituitary adenoma. Purpose: To determine if QoL is altered after hormonal replacement has been achieved in patients with pituitary deficiencies. Methods: A total of 40 patients with one or more pituitary dysfunctions and no other co-morbidities were evaluated pre and 6 months post normalization of pituitary deficiencies. QoL was evaluated using a disease specific tool: Domains of Life Function Scale for Patients with Pituitary Adenomas (DOLFS).  Possible scores were calculated in each area of functioning and compared between pre and post treatment groups. The presence and size of pituitary tumor, gender and axes of dysfunction were also evaluated for each group. Results: All patients reported experiencing one or more bothersome and persistent QoL deficits after adequate hormonal replacement. Post treatment scores for cognitive dysfunction were lower or improved (33/40 pre treatment versus 28/40 post treatment).  The same was evident for sexual function and intimacy (22/28 versus 19/28) and physical symptoms (88/116 versus 79/116). The remainder of dysfunctions, including anxiety, emotional lability, and motivation were largely unchanged pre and post treatment. Conclusion: QoL is reduced for the majority of patients with pituitary dysfunction despite adequate hormonal replacement. In order to improve QoL for such patients, more research is needed in each of the 6 domains identified in the DOLFS.  Following this, appropriate targeted treatments need to be developed to address persistent dysfunctions.
Keywords:
Pituitary dysfunction; Metabolic functions
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5361
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleIS QUALITY OF LIFE RESTORED WITH MEDICATION IN PATIENTS WITH PITUITARY DEFICITS ?en_GB
dc.identifier.urihttp://hdl.handle.net/10755/211524-
dc.description.abstractBackground: The pituitary is considered the ‘ master gland’ for its role in  directing  multiple broad functions including:  gonadal and reproduction functions, metabolic functions , somatic growth,  stress response and more  specific functions in water and electrolyte balance, blood pressure control, glucose control, weight management, sleep and mood control and more. Disturbances in one or more of these functions affect the individual’s life quality (QoL) to degrees that vary according to such factors as age, gender, culture and the meaning of the impact of the deficiency to the individual. Pituitary deficiencies usually occur from congenital pituitary damage, from injury (direct or indirect), inflammation or from the impact of a pituitary tumor.  Representing 15% of all brain tumors, pituitary tumors affect up to 27% of the population.  Estimates vary, but pituitary dysfunction has been reported in: 1: 8,000 people worldwide; 1: 5 patients after brain injury; 45:100 patients after subarachnoid hemorrhage: 2:3 patients with a symptomatic pituitary adenoma. Purpose: To determine if QoL is altered after hormonal replacement has been achieved in patients with pituitary deficiencies. Methods: A total of 40 patients with one or more pituitary dysfunctions and no other co-morbidities were evaluated pre and 6 months post normalization of pituitary deficiencies. QoL was evaluated using a disease specific tool: Domains of Life Function Scale for Patients with Pituitary Adenomas (DOLFS).  Possible scores were calculated in each area of functioning and compared between pre and post treatment groups. The presence and size of pituitary tumor, gender and axes of dysfunction were also evaluated for each group. Results: All patients reported experiencing one or more bothersome and persistent QoL deficits after adequate hormonal replacement. Post treatment scores for cognitive dysfunction were lower or improved (33/40 pre treatment versus 28/40 post treatment).  The same was evident for sexual function and intimacy (22/28 versus 19/28) and physical symptoms (88/116 versus 79/116). The remainder of dysfunctions, including anxiety, emotional lability, and motivation were largely unchanged pre and post treatment. Conclusion: QoL is reduced for the majority of patients with pituitary dysfunction despite adequate hormonal replacement. In order to improve QoL for such patients, more research is needed in each of the 6 domains identified in the DOLFS.  Following this, appropriate targeted treatments need to be developed to address persistent dysfunctions.en_GB
dc.subjectPituitary dysfunctionen_GB
dc.subjectMetabolic functionsen_GB
dc.date.available2012-02-20T12:00:10Z-
dc.date.issued2012-02-20T12:00:10Z-
dc.date.accessioned2012-02-20T12:00:10Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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