Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct;27(5):545-554.
doi: 10.1007/s11102-024-01460-6. Epub 2024 Sep 25.

Shared decision-making and detection of comorbidities in an online acromegaly consultation with and without the Acromegaly Disease Activity Tool ACRODAT® using the simulated person approach

Anna Lena Friedel #  1   2   3 , Lisa Schock #  4   5   6   7 , Sonja Siegel  1   3   8 , Angelika Hiroko Fritz  9 , Nicole Unger  8   10 , Birgit Harbeck  11   12 , Philipp Dammann  1   3   8 , Ilonka Kreitschmann-Andermahr  1   3   8
Affiliations

Shared decision-making and detection of comorbidities in an online acromegaly consultation with and without the Acromegaly Disease Activity Tool ACRODAT® using the simulated person approach

Anna Lena Friedel et al. Pituitary. 2024 Oct.

Abstract

Objective: A patient-centered approach to the management of acromegaly includes disease activity control, shared decision-making and identification of comorbidities. The Acromegaly Disease Activity Tool (ACRODAT®) is intended to assist physicians in providing such holistic management. The present study investigated this claim using the simulated person (SP) approach.

Methods: We studied patient-doctor interaction via online video consultation in a randomized prospective study design with SPs trained to simulate a specific acromegaly profile. We analyzed the proportion of conversation time devoted to health content and the specific acromegaly and comorbidity relevant categories mentioned in the conversation. We collected physicians' feedback on the usefulness of ACRODAT®, SPs subjective perception of the quality of the conversation and compared consultations with and without ACRODAT® using a qualitative approach.

Results: The sample (N = 30) consisted of endocrinologists treating patients with acromegaly in Germany. For SP-physician interactions (N = 60), the proportion of time spent on conversation content (e.g. IGF-I, quality of life) was distributed according to the focus of the patient profile. Comorbidities were less well identified than the need for a change in therapy. Only 18.3% of the SPs were actively asked to participate in the decision-making process. ACRODAT® did not lead to any significant differences in the course of the discussion.

Conclusions: Shared decision-making was underrepresented in this SP-physician interaction in acromegaly management. Physicians adapted the content of the discussion to the SP's needs, but did not adequately address comorbidities. According to the analysis criteria used, ACRODAT® did not contribute to a more holistic patient management in the present study.

Keywords: ACRODAT®; Acromegaly; Comorbidity; Shared decision-making; Simulation person.

PubMed Disclaimer

Conflict of interest statement

IKA and NU and JH received research support and/or travel grants and/or lecture or advisory board honoraria from Recordati Rare Diseases GbmH Germany, IPSEN Pharma GmbH Germany, Advanz Pharma GmbH, Pfizer Pharma GmbH Germany and Pfizer Co., all of which are manufactures of acromegaly medications. SoS received research support and/or travel grants and/or consultation fees from IPSEN Pharma GmbH Germany, Advanz Pharma GmbH, Pfizer Pharma GmbH Germany and Pfizer Inc. BH received research support and/or travel grants and/or lecture or advisory board honoraria from Recordati Rare Diseases GmbH, Pfizer Pharma GmbH Germany and Alexion Pharma Germany GmbH. LS, ALF, AHF and PD declare to have no conflict of interest in relation to the content of this article.

Figures

Fig. 1
Fig. 1
Key learning points of the four SPs
Fig. 2
Fig. 2
Study design
Fig. 3
Fig. 3
Percentage conversation time divided by the four SPs
Fig. 4
Fig. 4
Specific categories of the four SPs with superordinate learning points and their mentioning in the talk
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Fleseriu M et al (2022) Acromegaly: pathogenesis, diagnosis, and management. Lancet Diabetes Endocrinol 10(11):804–826. 10.1016/s2213-8587(22)00244-3 - PubMed
    1. Kreitschmann-Andermahr I et al (2017) Predictors of quality of life In 165 patients with acromegaly: Results From a Single-center study. Endocr Pract 23(1):79–88. 10.4158/ep161373.Or - PubMed
    1. Siegel S et al (2021) Illness-related burden, personal resources and need for support in patients with acromegaly: results of a focus group analysis. Growth Horm IGF Res 60–61. 10.1016/j.ghir.2021.101422 - PubMed
    1. Irving G et al (2017) International variations in primary care physician consultation time: a systematic review of 67 countries. BMJ Open 7(10):e017902. 10.1136/bmjopen-2017-017902 - PMC - PubMed
    1. Lundie M, Sisco J, van der Lely AJ (2019) ACRODAT® and AcroVoice: an insight into a holistic approach to the management of acromegaly. Pituitary 22(6):647–648. 10.1007/s11102-019-00994-4 - PMC - PubMed

LinkOut - more resources