A medical chart audit to assess endocrinologist perceptions of the burden of endogenous Cushing’s syndrome Review


Authors: Page-Wilson, G.; Oak, B.; Silber, A.; Meyer, J.; O’Hara, M.; Geer, E. B.
Review Title: A medical chart audit to assess endocrinologist perceptions of the burden of endogenous Cushing’s syndrome
Abstract: Purpose: This study was undertaken to assess the unmet needs within the endogenous Cushing’s syndrome (CS) care paradigm from the endocrinologist’s perspective, including data abstracted from patient charts. The study evaluated endocrinologists’ perceptions on burden of illness and treatment rationale along with the long-term clinical burden of CS, tolerability of CS treatments, and healthcare resource utilization for CS. Methods: Retrospective medical chart data from treated patients with a confirmed diagnosis of CS was abstracted using a cross-sectional survey to collect data from qualified endocrinologists. The survey included a case report form to capture patient medical chart data and a web-enabled questionnaire to capture practitioner-level data pertaining to endocrinologists’ perceptions of disease burden, CS treatments, and treatment attributes. Results: Sixty-nine endocrinologists abstracted data from 273 unique medical charts of patients with CS. Mean patient age was 46.5 ± 13.4 years, with a 60:40 (female:male) gender split. The mean duration of endogenous CS amongst patients was 4.1 years. Chart data indicated that patients experienced a high burden of comorbidities and symptoms, including fatigue, weight gain, and muscle weakness despite multi-modal treatment. When evaluating treatments for CS, endocrinologists rated improvement in health-related quality of life (HRQoL) as the most important treatment attribute (mean score = 7.8; on a scale of 1 = Not at all important to 9 = Extremely important). Surgical intervention was the modality endocrinologists were most satisfied with, but they agreed that there was a significant unmet treatment need for patients with CS. Conclusion: Endocrinologists recognized that patients with CS suffered from a debilitating condition with a high symptomatic and HRQoL burden and reported that improvement in HRQoL was the key treatment attribute influencing their treatment choices. This study highlights unmet needs for patients with CS. Patients with CS have a high rate of morbidity and comorbidity, even after treatment. © The Author(s) 2024.
Keywords: adult; controlled study; middle aged; patient satisfaction; retrospective studies; major clinical study; drug tolerability; fatigue; review; drug efficacy; drug safety; quality of life; morbidity; cohort analysis; retrospective study; health care utilization; health economics; questionnaire; medical record; comorbidity; muscle weakness; cross-sectional study; cross-sectional studies; gender; personal experience; perception; hypophysis tumor; cushing syndrome; hypercortisolism; endocrinologist; disease burden; humans; human; male; female; endocrinologists; pituitary tumor; cushing’s disease; cushing’s syndrome; clinical audit; body weight gain; unmet medical need
Journal Title: Pituitary
Volume: 27
Issue: 2
ISSN: 1386-341X
Publisher: Springer  
Date Published: 2024-04-01
Start Page: 129
End Page: 140
Language: English
DOI: 10.1007/s11102-023-01371-y
PUBMED: 38189862
PROVIDER: scopus
PMCID: PMC11009763
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Eliza B. Geer -- Source: Scopus
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  1. Eliza Brevoort Geer
    50 Geer