title: Impact of adult growth hormone deficiency on daily functioning and well-being.
abstract: BACKGROUND
  Adult Growth Hormone Deficiency (AGHD) is a debilitating condition resulting from tumors, pituitary surgery, radiation of the head, head injury, or hypothalamic-pituitary disease. This qualitative study was conducted to better understand the multi-faceted impacts and treatment effects of GHD on adult patients' daily lives.Seven focus groups and four telephone interviews were conducted in three countries. Eligible AGHD patients were age 22 or older who had started and stopped growth hormone treatment at least once as an adult. Transcripts were analyzed thematically.
  
  
  RESULTS
  Thirty-nine patients were interviewed; majority etiology was pituitary disease or tumor (62%). Thirty-four patients (87%) were currently on growth hormone replacement therapy; therapy initiation mean age was 43 years. Analysis identified five domains of disease impact: 1) Psychological Health--changed body or self-image and negative emotional impacts; 2) Physical Health--problems with sleep/fatigue, sex drive, weight gain, hair, skin, muscle/bone loss; 3) Cognition--concentration or memory trouble; 4) Energy Loss and its negative impacts (productivity, exercise, chores, socialization, or motivation); and 5) Treatment Effect--treatment enhances quality of life, enabling patients to increase effort (exercise, chores, or work improvements). Energy and sleep are improved. Saturation of themes was reached after the sixth focus group. A conceptual model of GHD disease impacts was developed.
  
  
  CONCLUSIONS
  Untreated AGHD has significant negative impacts for patients, which treatment often improves. It is important for clinicians and researchers to understand these multiple impacts so that they can address them in individualized treatment plans and incorporate them when assessing treatment outcomes.
authors.affiliation: The Brod Group, 219 Julia Avenue, Mill Valley, CA 94941, USA. mbrod@thebrodgroup.net.
authors.forename: Meryl
authors.initials: M
authors.lastname: Brod
authors.forename: Betsy
authors.initials: B
authors.lastname: Pohlman
authors.forename: Lise
authors.initials: L
authors.lastname: Højbjerre
authors.forename: Johan Erpur
authors.initials: JE
authors.lastname: Adalsteinsson
authors.forename: Michael Højby
authors.initials: MH
authors.lastname: Rasmussen
mesh_terms: D000328:Adult; D003071:Cognition; D005221:Fatigue / Q000150:complications; D005260:Female; D013006:Growth Hormone / Q000172:deficiency*; D006262:Health; D006801:Humans; D008297:Male; D008568:Memory; D011788:Quality of Life; D055815:Young Adult
chemical_list: D013006:Growth Hormone