The care continuum in acromegaly: how patients, nurses, and physicians can collaborate for successful treatment experiences

Figures & data

Table 1 Characteristics of available SSAs indicated for acromegaly

SSA	Formulation	Administration
Lanreotide	Long-acting depot/autogel	Deep subcutaneous injection every 28 days
		Approved for extended dosing intervals of 6–8 weeks Can be administered by self- or partner injection
Octreotide	Long-acting depot	Intramuscular injection every 28 days Administered by a HCP at the clinic or through a home nurse injection program
Pasireotide	Long-acting depot	Intramuscular injection every 28 days Administered by a HCP at the clinic or through a home nurse injection program

Abbreviations: SSA, somatostatin analog; HCP, health care professional.

Figure 1 Dialog map.

Note: *Follow-up should occur every 6 months to 1 year, depending on laboratory results, symptoms, and AEs.
Abbreviations: AE, adverse event; ER, emergency room; LAR, long-acting release; SAE, serious adverse event.

Table 2 Resources for patients with acromegaly

Purpose	Resource
Administration and adherence	Automated adherence reminders: emails, phone calls, letters, and text messages Mobile administration program: mobile HCPs deliver long-acting octreotide injections at home or at a convenient location
Symptom tracking	Diary of symptoms, test results, and side effects
	Regular appointment schedule
Patient education and emotional support	Acromegaly info (http://www.acromegalyinfo.com)
	Hormone Health network (http://www.hormone.org)
	Pituitary Disorders (http://www.pituitarydisorder.net)
	Pituitary Foundation (http://www.pituitary.org.uk)
	Pituitary Society (http://www.pituitary-society.org)
	You and Your Hormones (http://www.yourhormones.info)
	Pituitary network Association (http://www.pituitary.org)
	Acromegaly Community (http://www.acromegalycommunity.com)
	Additional support groups and educational resources may be found through the endocrine societies of individual countries/regions
Financial resources for patients without publicly funded health care	Financial assistance for lanreotide (http://acromegaly.somatulinedepot.com/resources/copay-savings-programs)
	Financial assistance for octreotide and pasireotide (1-877-LAr-inFO, http://www.endocrineaccessnow.com)
	Additional financial information may be found through the endocrine societies of individual countries/regions

Abbreviation: HCP, health care professional.

Table 3 Factors that can impede or promote adherence to chronic medical therapy

Adherence barriers	Adherence promoters
Forgetting to take medication Anxiety (eg, needle phobia) Lack of family support Perceived lack of efficacy Coping with adverse events Depression Treatment fatigue Life disruptions Financial concerns Perceived lack of HCP support Lack of emotional self-sufficiency	Automated reminders to take medication Self-efficacy Family support Satisfaction with current treatment Keeping a symptom diary Seeing improvements in symptoms Rewarding oneself after injections Availability of peer-to-peer patient support Inspiring other patients Perceived HCP support Patient’s understanding of the regimen

Abbreviation: HCP, health care professional.