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Learning Objective 1: Use DOLFS scale to identify indicative life function changes and deficits in patients with functional and non functional pituitary adenomas
Learning Objective 2: Describe deficits in patient centered outcomes amenable to nursing therapeutic regimen for a patient with a pituitary adenoma.
Background: Pituitary tumors represent the third most common brain tumor, with prevalence estimates of 15-27%. The extent of life function changes for these patients has not been determined. Current treatments focus on biochemical normalization and fail to address the full range of functional changes. The need to demonstrate efficacious, cost effective clinical outcomes requires comprehensive measurement of disease related effects on life functions and the development of new methods of outcomes measurement. The literature provides little agreement on the definition or constitution of quality of life (QoL) with respect to pituitary diseases. Many different tools have been used to demonstrate impaired QoL in patients with hypersecretory and large (macro) adenomas. However non-secretory micro adenomas have simply been presumed to be asymptomatic. Current evidence indicates that normalization of pituitary hormonal levels is not necessarily synonymous with improved life function and QoL. Additionally, there is no longitudinal data that reflects progressive QoL changes during treatment.
Purpose: To develop a dedicated, comprehensive metric for the measurement of life functions in multiple domains that impact QoL in patients with all types of pituitary tumors; to determine the impact of non-secretory pituitary tumors on QoL; and to standardize future research efforts.
Method and Results:A total of forty subjects with pituitary adenomas (without concomitant disease) were asked to complete a questionnaire regarding their ability to function physically socially, emotionally, cognitively, spiritually and economically. Illness beliefs, sense of control and some personality traits were included. Results are pending at this time.
Conclusion: Using a standardized instrument with a clear definition of life functions and QoL in patients with pituitary tumors broadens the measurement of treatment outcomes for this population. This enables the targeting of treatment and further research into specific patient deficits. This addresses patient preferred outcomes rather than solely what is biochemically important to the provider.