OBJECTIVES: Adult growth hormone deficiency (AGHD) is a rare disease characterised by abnormal body composition, reduced strength and exercise capacity and impaired psychological wellbeing. An advisory board of leading Central and Eastern European (CEE) endocrinologists was assembled to gain insights into the status of AGHD care in the CEE region. Topics of discussion included the position of adult hypopituitarism/AGHD in health system priorities, availability and affordability of treatments, awareness of AGHD, practice guidelines used in CEE countries and provisions for long-term care of patients. DESIGN: Prior to the meeting, the advisors were asked to summarise, using an itemised survey questionnaire, the usual standards of care for patients with AGHD in their country. At the meeting, the panel of experts discussed the findings and thereby elucidated similarities and differences among CEE countries; these were compared with international guideline-recommended practices for AGHD. RESULTS: All CEE countries involved reported having some type of infrastructure in place for care of patients with GHD transitioning from adolescence to adulthood. Most countries reported having at least one specialist centre for patients with AGHD. The main variations across the region included initial entry into healthcare systems, tests required to confirm AGHD diagnosis and medication reimbursement by health authorities. Most CEE countries relied on international society-led guidelines, while some countries have developed national guidelines. CONCLUSION: The CEE Adult Endocrinology Advisory Board meeting recognised considerable diversity in the care and patient pathways for AGHD across CEE countries. Additional work is needed to optimise care of patients with AGHD in the CEE region.

C Davila University of Medicine and Pharmacy National Institute of Endocrinology Bucharest Romania

Children's University Hospital Riga Stradin's University Riga Latvia

Clinical Center of Endocrinology and Gerontology Medical University Sofia Bulgaria

Department of Internal Medicine 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Internal Medicine University Hospital of Comenius University Bratislava Slovakia

Department of Pediatrics Endocrinology Diabetology with a Cardiology Unit Medical University of Bialystok Bialystok Poland

Faculty of Medicine University of Ljubljana Slovenia

Neuroendocrine Department Clinic for Endocrinology Diabetes and Metabolic Diseases Clinical Center of Serbia Medical Faculty University of Belgrade Serbia

Pfizer Innovative Health Brussels Belgium

Pfizer New York City USA

Rabin Medical Center Petah Tiqva Israel

Semmelweis University Budapest Hungary

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