Knowledge and attitudes of primary care physicians regarding acromegaly: a survey study with multinational participation.

Background: Acromegaly is a disease with high morbidity and mortality rates. The role of primary care physicians is very important in the early diagnosis of acromegaly. The present study aims to determine the knowledge and attitudes of primary care physicians about acromegaly in different countries worldwide.

Methods: The survey consisted of 33 questions prepared in English and Turkish and was administered 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 administered in person. 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 of acromegaly knowledge and the 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 was better known by Asian/African physicians (p = 0.01 and p = 0.009, respectively). The rate of correct answers to the question "Old photographs can be informative in patients suspected to have acromegaly" was higher in the Turkish and Asian/African groups (p < 0.001). Only 36.1% of the Turkish physicians, 29.8% of the European physicians, and 31.3% of the Asian/African physicians knew that serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels were diagnostic indicators for acromegaly. Colon cancer and goitre incidences were increased in acromegaly patients. These comorbidities were better known by Asian/African primary care physicians than by Turkish and European primary care physicians (p < 0.001 and p = 0.032, respectively). Only 18.6% of Turkish and 13% of European physicians knew that surgery was the treatment of choice for acromegaly patients. The rate of correct answers to this question was higher for Asian/African physicians (59.4%) (p = 0.003).

Conclusion: Knowledge of primary care physicians regarding acromegaly should be increased through workshops, seminars, and subject-focused courses.