title: Healthcare utilization, quality of life and patient-reported outcomes during two years of GH replacement therapy in GH-deficient adults--comparison between Sweden, The Netherlands and Germany.
abstract: OBJECTIVE
  This study set out to determine the change in quality of life (QoL) and healthcare utilization during 2 years of growth hormone (GH) replacement therapy in adults with GH deficiency. Data were compared from three European countries.
  
  
  METHODS
  Analysis was made from KIMS, the Pfizer International Metabolic Database on adult GH deficiency.
  
  
  METHODS
  QoL and healthcare utilization were measured at baseline and after 1 and 2 years of GH replacement in patient cohorts from Sweden (n = 302), The Netherlands (n = 103) and Germany (n = 98). QoL was assessed by the QoL-Assessment in Growth Hormone Deficient Adults (QoL-AGHDA) questionnaire, and the KIMS Patient Life Situation Form was used to evaluate healthcare utilization.
  
  
  RESULTS
  QoL improved significantly (P < 0.0001) and comparably in all three cohorts. The improvement was seen during the first year of treatment and QoL remained improved during the second year. The number of days in hospital was reduced by 83% (P < 0.0001) during GH replacement. There were no country-specific differences either at baseline or during follow-up. The same was true for the number of days of sick leave (reduction of 63%; P = 0.0004). Significant reductions were recorded in the number of doctor visits in each of the three cohorts after 2 years of GH replacement (P < 0.05).
  
  
  CONCLUSIONS
  This study provides a detailed comparative analysis of GH replacement therapy in GHD patients in three European countries. Despite some differences in treatment strategies, the beneficial effects on QoL, patient-reported outcomes and healthcare utilization are essentially similar in the healthcare environment of Western European countries.
authors.affiliation: Medical Department, Pfizer GmbH, Karlsruhe, Karlsruhe, Germany. saller@endoscience.de
authors.forename: Bernhard
authors.initials: B
authors.lastname: Saller
authors.forename: Anders F
authors.initials: AF
authors.lastname: Mattsson
authors.forename: Peter H
authors.initials: PH
authors.lastname: Kann
authors.forename: Hans P
authors.initials: HP
authors.lastname: Koppeschaar
authors.forename: Johan
authors.initials: J
authors.lastname: Svensson
authors.forename: Marjolein
authors.initials: M
authors.lastname: Pompen
authors.forename: Maria
authors.initials: M
authors.lastname: Koltowska-Häggström
mesh_terms: D000328:Adult; D005260:Female; D005858:Germany; D006295:Health Resources / Q000706:statistics & numerical data*; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013548:Sweden
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I