{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:01:36Z","timestamp":1762542096369},"reference-count":7,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,12]],"date-time":"2013-03-12T00:00:00Z","timestamp":1363046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Guidelines on the clinical use of growth hormone therapy in adults were issued by the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> National Institute for Clinical Excellence (<jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content>) in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ugust 2003. We conducted a retrospective clinical audit on the use of growth hormone (<jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content>) in Scotland to evaluate the use of these guidelines and their impact on clinical practice. The audit had two phases. In phase I, the impact of <jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content> criteria on specialist endocrine practice in starting and continuing <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> replacement was assessed. In phase II, the reasons why some adults in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>cotland with growth hormone deficiency were not on replacement therapy were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cross\u2010sectional case note review was carried out of all adult patients being followed up for growth hormone deficiency during the study period (1 <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>arch 2005 to 31 March 2008). Phase <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content> of the audit included 208 patients and phase <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> 108 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sellar tumours were the main cause of <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> deficiency in both phases of the audit. In phase <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>, 53 patients (77%) had an <jats:styled-content style=\"fixed-case\">AGHDA\u2010Q<\/jats:styled-content>o<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content> score &gt;11 documented before commencing <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> post\u2010<jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content> guidance, compared with 35 (25%) pre\u2010<jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content> guidance. Overall, only 39 patients (18%) met the full <jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content> criteria for starting and continuing <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> (pre\u2010<jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content>, 11%; post\u2010<jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content>, 35%). Phase II indicated that the main reasons for not starting <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> included perceived satisfactory quality of life (<jats:italic>n<\/jats:italic>\u00a0=\u00a047, 43%), patient reluctance (16, 15%) or a medical contraindication (16, 15%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although the use of quality of life assessments has increased following publication of the <jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content> guidelines, most adults on <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> in Scotland did not fulfil the complete set of <jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content> criteria. The main reason for not starting <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> therapy in adult <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content>\u2010deficient patients was perceived satisfactory quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12017","type":"journal-article","created":{"date-parts":[[2012,8,18]],"date-time":"2012-08-18T12:25:29Z","timestamp":1345292729000},"page":"571-576","source":"Crossref","is-referenced-by-count":5,"title":["An audit of growth hormone replacement for <scp>GH<\/scp>\u2010deficient adults in <scp>S<\/scp>cotland"],"prefix":"10.1111","volume":"78","author":[{"given":"Sam","family":"Philip","sequence":"first","affiliation":[{"name":"Aberdeen Royal Infirmary Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isobel","family":"Howat","sequence":"additional","affiliation":[{"name":"Western Infirmary Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maggie","family":"Carson","sequence":"additional","affiliation":[{"name":"Edinburgh Royal Infirmary Edinburgh UK Scotland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Booth","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Campbell","sequence":"additional","affiliation":[{"name":"Western Infirmary Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Grant","sequence":"additional","affiliation":[{"name":"Western Infirmary Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Patterson","sequence":"additional","affiliation":[{"name":"Ninewells Hospital and Medical School Dundee UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Schofield","sequence":"additional","affiliation":[{"name":"Ninewells Hospital and Medical School Dundee UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Bevan","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Patrick","sequence":"additional","affiliation":[{"name":"Edinburgh Royal Infirmary Edinburgh UK Scotland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham","family":"Leese","sequence":"additional","affiliation":[{"name":"Ninewells Hospital and Medical School Dundee UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Connell","sequence":"additional","affiliation":[{"name":"Western Infirmary Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,3,12]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"1","article-title":"Clinical effectiveness and cost\u2010effectiveness of growth hormone in adults in relation to impact on quality of life: a systematic review and economic evaluation","volume":"6","author":"Bryant J.","year":"2003","journal-title":"Health technology assessment"},{"key":"e_1_2_7_3_1","volume-title":"Human growth hormone (somatropin) in adults with growth hormone deficiency","author":"National Institute for Clinical Excellence (NICE)","year":"2003"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008987922774"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.5.1905"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000087444"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"3929","DOI":"10.1210\/jcem.84.11.6088","article-title":"The effects of treatment and the individual responsiveness to growth hormone (GH) replacement therapy in 665 GH\u2010deficient adults. KIMS Study Group and the KIMS International Board","volume":"84","author":"Bengtsson B.A.","year":"1999","journal-title":"The Journal of clinical endocrinology and metabolism"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.03010.x"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcen.12017","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.12017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T11:08:31Z","timestamp":1700651311000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.12017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,12]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,4]]}},"alternative-id":["10.1111\/cen.12017"],"URL":"https:\/\/doi.org\/10.1111\/cen.12017","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,12]]}}}