The knowledge and attitudes of primary care physicians about acromegaly: a survey study with multinational participation

Abstract Background: Acromegaly is a disease with a high morbidity and mortality rate. The role of primary care physicians is very important in the early diagnosis of acromegaly. This study aims to determine the knowledge and attitudes of primary care physicians about acromegaly in different countries of the world. Methods: The survey, consisting of 33 questions prepared in English and Turkish, was applied to a total of 396 primary care physicians, 280 of whom were from Turkey, 84 from European countries, 28 from Asian countries, and 4 from Nigeria. Mostly, the survey was administered via Google Forms sent to social media groups of primary care physicians. Some of the surveys were applied face-to-face. The survey included 12 questions about the clinical manifestations, six questions about the diagnosis, 12 questions about the comorbidities, one question about the treatment, and two questions about the prognosis of acromegaly. Data about acromegaly knowledge and attitudes of physicians were evaluated using the Chi-square test. Results: The presence of acral findings in acromegaly was better known by Turkish physicians (96.8%) compared to Asian/African (84.4%) and European (84.5%) physicians (p<0.001). The presence of generalized visceromegaly and excessive sweating in acromegaly was better known by Asian/African physicians (p=0.01 and p=0.009). “Old photographs can be informative in patients suspected to have acromegaly”, the rate of correct answers to this question was higher in Turkish and Asian/African groups (p<0.001). Only 36.1% of Turkish physicians, 29.8% of European physicians, and 31.3% of Asian/African physicians knew that serum GH and IGF-1 levels were diagnostic tests for acromegaly. Although 64.3% of Turkish physicians knew that serum IGF-1 level was the single best test to be chosen in patients suspected to have acromegaly, the rate of the correct answers to this question was low in European (36.9%) and Asian/African (46.9%) physicians (p<0.001). Only 18.6% of Turkish and 13% of European physicians knew that surgery was the treatment of choice in acromegaly. The rate of correct answers to this question was higher in Asian/African physicians (59.4%) (p=0.003). Conclusion: The knowledge of primary care physicians about acromegaly should be increased through workshops, seminars, and subject-focused courses.