A disease-specific measure of quality of life for adults with growth hormone deficiency: improvement in quality of life after growth hormone replacement therapy

This study set out to develop a health-related quality-of-life measure specifically for adults with growth hormone deficiency (GHD) and to use this measure to assess the impact of growth hormone (GH) replacement therapy. Two measures the Impact Scale and the Life Fulfilment Scale - were developed after clinical interviews with 12 adults with GHD. Four other scales were also used: the Nottingham Health Profile, the Hospital Anxiety and Depression Questionnaire, the Self Esteem Questionnaire and the Mental Fatigue Questionnaire. The six scales were then completed by 30 adults with GHD (10 men, 20 women; mean age, 35.5 years; mean stimulated serum GH, 3 mlU/l) receiving either daily GH, 0.25 lU/kg/week for 12 months, or placebo for 6 months and then GH for 6 months, during a randomized double-blind placebo-controlled study. All six scales had test/retest correlations above 0.7. The Impact, Life Fulfilment and Mental Fatigue scales had Cronbachs alpha scores greater than 0.6. The quality-of-life measures were thus reliable and consistent. The Impact and Life Fulfilment scales correlated with many physical and psychological domains from the four other scales. GH replacement therapy for 12 months resulted in increased energy levels (P < 0.01). Small improvements were found in life fulfilment and in the perceived impact of GHD. In conclusion, these measures of quality of life for adults with GHD are valid and reliable tools, which show that GH replacement has some beneficial effects on quality of life in adults with GHD.