Patient-reported impacts of a conservative management programme for the clinically inapparent adrenal mass

摘要

The aim of this study was to assess patient-reported impacts and health-related quality of life (HRQL) of a 2-year follow-up programme in a large cohort of patients with stationary, non-functioning, adrenal incidentalomas (AIs) in western Sweden. 145 patients (mean age 68 years, 62 females) with AI from a prospective study in western Sweden were studied. All had completed a 2-year follow-up programme by November 2007, without evidence of adrenal malignancy or hormone over-production. To evaluate patient-reported impacts and HRQL, an eight-item adrenal incidentaloma impact questionnaire was used retrospectively, together with the hospital anxiety and depression scale, and the short form-36. There were 111 patients (mean age 67 years, 63 females) who responded to the questionnaire (response rate 77 ). 77 reported that the AI diagnosis had caused them to be worried; however, fewer than 20 had thought about the lesion often during the follow-up programme, and only 3 had felt that it had a large impact on their current daily life. Only 4 stated that the follow-up programme had been a negative experience, nevertheless 10 reported a negative impact on their HRQL during the follow-up programme. Only 2 stated that release from follow-up caused worry to any degree. In total, 29 had possible anxiety, and 30 had possible depression, probably reflecting significant co-morbidity. Possible anxiety correlated with a more negative experience of the follow-up programme. In conclusion, the 2-year follow-up programme for patients with AI was well tolerated. Nonetheless, a small number remained worried throughout follow-up, suggesting the need for tailored counselling in individual patients to ameliorate negative impacts of follow-up.