Quality of Life in Short Adults

Abstract

The use of (costly) growth hormone (GH) treatment in short children is often justified by the assumption that short stature considerably reduces quality of life in adults. We tested this assumption in 5 groups of short adults: 25 patients with isolated GH deficiency; 17 male patients with childhood onset renal failure; 25 women with Turner syndrome and 26 patients who were presented as a child to a paediatrician for idiopathic short stature. A group of 44 short individuals with presumably idiopathic short stature, who had not been presented to a paediatrician for short stature, was sampled from the general population (‘normal shorts’). We measured quality of life in terms of socio-economic variables, the Nottingham Health Profile and time trade-off. The mean height of most groups was close to the 3rd percentile. The chance of having a partner was low for all groups, except for the normal shorts. Problems with job application were only reported in Turner syndrome. The scores on the Nottingham Health Profile were all within the normal range, but GH-deficient adults had a higher score on the domain energy than normal shorts. Women with Turner syndrome, individuals with renal failure, and those with idiopathic short stature had a wish to be taller, with an estimated reduction in quality of life of 2–4% (time trade-off). As the normal shorts did not show any sign of a reduced quality of life, we falsify the assumption of a direct relation between short stature and quality of life. The complaints of patients with idiopathic short stature around the 3rd percentile seem to be the result of unsuccessful coping strategies.

Assessment of Health-Related Quality of Life and Patient Satisfaction in Children and Adolescents with Growth Hormone Deficiency or Idiopathic Short Stature – Part 1: A Critical Evaluation of Available Tools

“…Both, generic and disease-specific quality of life instruments have been used in studies of adults with GHD [18, 19]. Among the generic variety, the Nottingham Health Profile [20, 21], the Psychological General Well-Being [22] and the Short Form 36 Health Survey (SF-36) [23,24,25] have frequently been employed.…”

“…Rekers-Mombarg et al [24]. Busschbach et al [25] assessed the impact of SS on HrQoL using time-trade-off.…”

Growth monitoring for short stature: update of a systematic review and economic model

“…These aggregated QALY gains were taken from the previous Health Technology Assessment (HTA) journal publication. 2 They were based on two published studies 21,22 and clinical opinion. Using an aggregated estimate of lifetime QALY gains as an outcome is not a commonly used method and the results presented in this analysis can be interpreted as the gains in QALYs for each intervention.…”

“…As this review was conducted as an update to our previous assessment [Fayter D, et al A systematic review of the routine monitoring of growth in children of primary school age to identify growth-related conditions. Health Technol Assess 2007;11 (22)], searching covered a range of databases from January 2005 to November 2009 with no language or publication restrictions. As part of our search strategy, we aimed to identify new studies containing quality of life/utilities data to utilise in the economic model.…”

“…However, only two provided data that could be used in the economic model. 21,22 Data from these studies were supplemented by expert opinion to derive quality-adjusted life-year (QALY) gains from detecting and treating children with a growth problem early as a result of monitoring when compared with detecting and treating children late on an ad hoc basis assuming no growth monitoring. 2 For this project, we conducted an update of the searches for QoL data with the aim of obtaining utility data for use in the updated economic model.…”