Skip to main content
Top
Published in: Endocrine 1/2023

13-10-2022 | Cushing's Syndrome | Original Article

Patient reported outcomes and treatment satisfaction in patients with cushing syndrome

Authors: Maureen Rakovec, William Zhu, Adham M. Khalafallah, Roberto Salvatori, Amir H. Hamrahian, Gary L. Gallia, Masaru Ishii, Nyall R. London Jr., Murugappan Ramanathan Jr., Nicholas R. Rowan, Debraj Mukherjee

Published in: Endocrine | Issue 1/2023

Login to get access

Abstract

Purpose

Cushing Syndrome (CS) is a rare endocrine disorder associated with physical and mental symptoms that can drastically affect quality of life (QoL). This study characterizes QoL in patients with CS, describes their treatment experiences, and identifies patient subsets associated with decreased QoL or shared impressions of treatment.

Methods

A 136-question survey addressing QoL factors and treatment experiences was completed by adult patients with CS from the Cushing Support and Research Foundation. Patient demographics, tumor characteristics, and treatment information were collected. Bivariate analyses were conducted to determine if patients’ symptoms or treatment experiences were significantly associated with demographics or other variables.

Results

A total of 178 patients, predominantly female (94%) with mean age 53 years, completed the survey. Anxiety and/or depression (n = 163, 94%), loss of physical strength (n = 164, 93%), loneliness (n = 156, 90%), fatigue from treatment (n = 142, 89%), memory loss (n = 153, 88%), insomnia (n = 144, 83%), and pain (n = 141, 83%) were symptoms most commonly experienced by respondents. Patients experiencing delay of diagnosis >10 years were more likely to have suicidal thoughts (p = 0.002). Younger patients were more likely to express concerns about hair loss (p = 0.007), loneliness (p = 0.025), pain (p = 0.004), or the impact of CS on their marriage (p = 0.039) or children (p = 0.024).

Conclusion

This survey demonstrates CS impacts patients across many dimensions, emphasizing the need for holistic support. We identified patient subsets in which QoL may be improved with additional patient resources or provider attention.
Appendix
Available only for authorised users
Literature
9.
go back to reference M.N. Starkman, D.E. Schteingart, Neuropsychiatric manifestations of patients with Cushing’s syndrome. Relationship to cortisol and adrenocorticotropic hormone levels. Arch. Intern Med. 141(2), 215–219 (1981)CrossRef M.N. Starkman, D.E. Schteingart, Neuropsychiatric manifestations of patients with Cushing’s syndrome. Relationship to cortisol and adrenocorticotropic hormone levels. Arch. Intern Med. 141(2), 215–219 (1981)CrossRef
19.
go back to reference P. Gotch, Cushing’s syndrome from the patient’s perspective. Endocrinol. Metab. Clin. N. Am. 23, 607–617 (1994)CrossRef P. Gotch, Cushing’s syndrome from the patient’s perspective. Endocrinol. Metab. Clin. N. Am. 23, 607–617 (1994)CrossRef
24.
go back to reference M. Nock, G. Borges, E. Bromet et al. Cross-national prevalence and risk factors for suicidal ideation, plans, and attempts. Br. J. Psychiatry 192, 98–105 (2008)CrossRef M. Nock, G. Borges, E. Bromet et al. Cross-national prevalence and risk factors for suicidal ideation, plans, and attempts. Br. J. Psychiatry 192, 98–105 (2008)CrossRef
27.
go back to reference T.Y. Lin, J. Hanna, W.W. Ishak, Psychiatric symptoms in cushing’s syndrome: a systematic review. Innov. Clin. Neurosci. 17(1-3), 30–35 (2020) T.Y. Lin, J. Hanna, W.W. Ishak, Psychiatric symptoms in cushing’s syndrome: a systematic review. Innov. Clin. Neurosci. 17(1-3), 30–35 (2020)
29.
go back to reference J.W. Findling, H. Raff, Differentiation of pathologic/neoplastic hypercortisolism (Cushing’s syndrome) from physiologic/non-neoplastic hypercortisolism (formerly known as pseudo-Cushing’s syndrome). Eur. J. Endocrinol. 176(5), R205–R216 (2017). https://doi.org/10.1530/EJE-16-0946CrossRef J.W. Findling, H. Raff, Differentiation of pathologic/neoplastic hypercortisolism (Cushing’s syndrome) from physiologic/non-neoplastic hypercortisolism (formerly known as pseudo-Cushing’s syndrome). Eur. J. Endocrinol. 176(5), R205–R216 (2017). https://​doi.​org/​10.​1530/​EJE-16-0946CrossRef
32.
go back to reference M.A.E.M. Wagenmakers, R.T. Netea-Maier, J.B. Prins, T. Dekkers, M. Den Heijer, A.R.M.M. Hermus, Impaired quality of life in patients in long-term remission of Cushing’s syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism. Eur. J. Endocrinol. 167(5), 687–695 (2012). https://doi.org/10.1530/EJE-12-0308CrossRef M.A.E.M. Wagenmakers, R.T. Netea-Maier, J.B. Prins, T. Dekkers, M. Den Heijer, A.R.M.M. Hermus, Impaired quality of life in patients in long-term remission of Cushing’s syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism. Eur. J. Endocrinol. 167(5), 687–695 (2012). https://​doi.​org/​10.​1530/​EJE-12-0308CrossRef
Metadata
Title
Patient reported outcomes and treatment satisfaction in patients with cushing syndrome
Authors
Maureen Rakovec
William Zhu
Adham M. Khalafallah
Roberto Salvatori
Amir H. Hamrahian
Gary L. Gallia
Masaru Ishii
Nyall R. London Jr.
Murugappan Ramanathan Jr.
Nicholas R. Rowan
Debraj Mukherjee
Publication date
13-10-2022
Publisher
Springer US
Published in
Endocrine / Issue 1/2023
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-022-03214-5

Other articles of this Issue 1/2023

Endocrine 1/2023 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.