SAT-093 Better Late than Never - Kleinman's Explanatory Model for Acromegaly Management

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Abstract Disclosure: R.M. Pop: None. A. Szocs: None. I. Pascanu: None. Background: Acromegaly management is a cumbersome task and adherence to treatment represents a recurring issue due to the chronic nature of the disease, side effects of therapy, and patient perceptions of illness. Kleinman’s Explanatory Model provides a framework to explore patient beliefs and behaviors, which can influence adherence and treatment outcomes. Case Presentation: A 28-year male patient diagnosed at age twenty with GH excess caused by a pituitary adenoma, subsequently surgically removed (positive for SST2 receptors) entered the care of the current staff of the Endocrinology Department of Targu-Mures, Romania 4 years after diagnosis due to the previous carer’s retirement. He had never achieved biochemical control, despite negative imaging findings and progressive escalation of treatment (up to daily GH receptor antagonist), all interpreted in context of poor adherence (missed appointments, treatment cessation). He was confirmed to harbor an AIP mutation – variant of unknown significance. After 5 years of current team management, biochemical control hasn’t been achieved. To understand his perspective, the Kleinman’s eight questions were applied, revealing his belief that his illness was from birth, aggravated by work and causing pain, with no relief despite treatment. Moreover, other social, cultural, healthcare related factors were involved – different ethnicity, remote area with poor access to care, unemployment due to multiple medical appointments, national strict protocol for acromegaly treatment. All these elements led to reluctance in him following medical advice. Discussion: Addressing his concerns through culturally sensitive communication, shared decision-making, and patient education improved his engagement. By incorporating his beliefs into discussions and emphasizing treatment benefits in relatable terms, he ultimately agreed to recommendations and maintained adherence to medical therapy. This case highlights the importance of integrating patient-centered frameworks like Kleinman’s model to enhance adherence in chronic disease management. Conclusion: Understanding patient perspectives through Kleinman’s Explanatory Model at any time point during a chronic disease management can bridge gaps in communication, improve adherence, and optimize long-term outcomes in acromegaly. Presentation: Saturday, July 12, 2025

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