Comparative analysis of the practices of diagnostics and treatment of short stature, established in the outpatient clinics of general practitioners from Pleven and Varna

Abstract

Introduction: Normal growth of the child is an index of good health, but it is a limited in time process, and for this reason, timely diagnosis and start of treatment of children with short stature (SS) are crucial for achieving adequate adult height and good quality of life. Aim: The aim of the present interview is to study the knowledge of general practitioners (GPs) about growth disorders and to increase the informational level in the process of creating national referral criteria and algorithms for the management of children with SS. Materials and Methods: GPs from Pleven and Varna (n=40, mean age 54.5 ± 8.85 yrs, work experience 25.9 ± 8.8 yrs, working in urban settings – 75%, children in their practices 0-18 - 23 079) have completed a questionnaire with 20 questions. All interviewed GPs defined SS as a problem for children. Almost all of them (80%) indicated use of standards for growth evaluation. They claimed that they provided screening for early detection of SS and they knew where to send a child with growth deviation. The main cause of SS, according to GPs, is genetic predisposition (35%), and that both - GPs and parents, are active in diagnosis of SS (82.5%). However, GPs shared that they were faced with some difficulties in the diagnosis of SS because of the “unclear” path of the patient after directing him to a specialist and that was the reason some of the children with SS to remain undiagnosed. Conclusion: SS is a problem that GPs are conscious of, but there is a strong need of measurements for building the “route” of the patient with SS, starting from the first step – the general practitioner.