An evaluation of the Acromegaly Treatment Satisfaction Questionnaire (Acro-TSQ) in adult patients with acromegaly, including correlations with other patient-reported outcome measures: data from two large multicenter international studies

Pituitary. 2020 Aug;23(4):347-358. doi: 10.1007/s11102-020-01038-y.


Purpose: The Acromegaly Treatment Satisfaction Questionnaire (Acro-TSQ) is a new patient-reported outcome (PRO) measure for patients with acromegaly receiving injectable somatostatin analogs (SSAs) to assess clinical symptoms and adverse drug reaction interference, treatment satisfaction, and convenience. We evaluated its scale structure, reliability, validity, responsiveness, and what constitutes clinically meaningful change.

Methods: Data from two longitudinal studies (N = 79 and 82) of patients receiving a stable injectable SSA dose for ≥ 6 months who completed the Acro-TSQ and other collateral measures (e.g., AcroQoL, AIS, WPAI:SHP, EQ-5D-5L) were analyzed.

Results: The first study demonstrated internal consistency of the Acro-TSQ. However, several items had high ceiling effects, responsiveness could not be established, and the minimally important difference (MID) was not estimable. In the second study, factor analysis revealed six scales: Symptom Interference, Treatment Convenience, Injection Site Interference, GI Interference, Treatment Satisfaction, and Emotional Reaction. Internal consistency and test-retest reliability were confirmed; most scales demonstrated significant differences in mean scores by disease severity. Correlations between Acro-TSQ scales and other collateral measures exceeded 0.30 in absolute value, confirming convergent validity. Responsiveness in Acro-TSQ scale scores reflected improved disease control. The MID was estimated for Symptom Interference (10-12 points), Treatment Convenience (9-11) and GI Interference (8-10).

Conclusions: The Acro-TSQ is a brief, yet comprehensive tool to monitor important outcomes associated with injectable acromegaly SSA treatments. Its content reflects both disease and treatment burden as well as patient satisfaction, and its relevant for use in clinical studies.

Keywords: Acro-TSQ; Acromegaly; Measurement properties; Patient reported outcomes; Quality of life; Questionnaire; Validation.

Publication types

  • Multicenter Study

MeSH terms

  • Acromegaly / drug therapy*
  • Adenoma / drug therapy*
  • Adult
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Delayed-Action Preparations
  • Factor Analysis, Statistical
  • Female
  • Growth Hormone-Secreting Pituitary Adenoma / drug therapy*
  • Humans
  • Injections, Intramuscular
  • Injections, Subcutaneous
  • Male
  • Middle Aged
  • Minimal Clinically Important Difference
  • Netherlands
  • Octreotide / therapeutic use*
  • Patient Reported Outcome Measures*
  • Patient Satisfaction*
  • Peptides, Cyclic / therapeutic use*
  • Reproducibility of Results
  • Somatostatin / analogs & derivatives*
  • Somatostatin / therapeutic use
  • Surveys and Questionnaires
  • United Kingdom
  • United States


  • Antineoplastic Agents, Hormonal
  • Delayed-Action Preparations
  • Peptides, Cyclic
  • lanreotide
  • Somatostatin
  • Octreotide