Patient-reported outcomes in a Pituitary Tumor Center of Excellence (PTCOE)-aligned pituitary clinic compared with general endocrinology care.

PURPOSE: Pituitary Tumor Centers of Excellence (PTCOE) were developed to standardize multidisciplinary care for pituitary disorders; however, their impact on patient-reported outcomes remains insufficiently characterized. This study aimed to compare health-related quality of life, illness perception, and outpatient satisfaction between patients followed in a PTCOE-aligned, though not formally accredited, specialized pituitary clinic and those managed in general endocrinology clinics, and to identify organizational factors associated with these outcomes.

METHODS

In this cross-sectional study, 175 adults with prolactinoma (n = 70), non-functioning pituitary adenoma (n = 54), acromegaly (n = 35) and Cushing's disease (n = 16) were evaluated across two tertiary endocrinology centers. Patient-reported outcomes were assessed using validated Turkish versions of the SF-36, Illness Perception Scale, and Outpatient Satisfaction Scale.

RESULTS

Certain baseline clinical profiles differed significantly between the two groups, with patients in the specialized clinic exhibiting higher rates of pituitary surgery (63.9% vs. 32.1%, p = 0.001) and hypopituitarism (28.9% vs. 14.1%, p = 0.02). Patients in the specialized clinic showed significantly lower SF-36 Role Physical, Role Emotional, Social Functioning, and Bodily Pain scores (all p ≤ 0.03). Illness-perception patterns also diverged, with higher Timeline, Consequences, and Treatment Control scores in the specialized clinic. Outpatient satisfaction, however, was consistently higher across all subscales in the specialized clinic (all p ≤ 0.006). In multivariable analyses, clinic type, sex, hypopituitarism, surgical history, and follow-up duration independently contributed to variation in multiple patient-reported outcome domains.

CONCLUSION

PTCOE-aligned specialized care was associated with more favorable illness representations and higher patient satisfaction, even among cases with greater disease burden. This underscores the need for integrating patient-reported outcomes into the evaluation and refinement of pituitary care models.