Assessment of Family Physicians’ Knowledge, Awareness, and Management Approaches Concerning Precocious Puberty in Primary Care

Abstract

Aim: Precocious puberty (PP) is increasingly common and needs early recognition and referral in primary care. This study evaluated family physicians’ knowledge, awareness, and attitudes regarding PP, including diagnosis, etiology, endocrine disruptors, diagnostic methods, and treatment, as well as their association with clinical training.

Material and Methods: This cross-sectional, survey-based study included 157 family physicians (residents and specialists) working in primary care. A structured questionnaire consisting of 17 multiple-choice questions was developed based on current literature and expert review. The survey assessed physicians’ sociodemographic characteristics, knowledge of PP definition and age thresholds, recognition of clinical signs, awareness of etiological and environmental risk factors, use of Tanner staging, diagnostic approaches, referral practices, and treatment perspectives.

Results: A total of 157 physicians were included; 68.2% were residents and 31.8% were specialists. Physicians completing both pediatrics and pediatric endocrinology rotations more often identified the correct PP age limits for girls and boys (p<0.001 and p=0.022) and had higher awareness of clinical signs, causes, Tanner staging, referral, test ordering, and the effectiveness of gonadotropin-releasing hormone analog (GnRHa) therapy (p≤0.006). Compared with residents, specialists more often referred suspected cases to pediatric endocrinology and recognized GnRHa effectiveness, with differences most evident in rotation-based analyses.

Conclusion: Although family physicians possess basic knowledge of PP, substantial differences exist in awareness of male pubertal findings, endocrine disruptors, and diagnostic and treatment approaches. Structured training in pediatrics and pediatric endocrinology may be associated with greater awareness and support early recognition, appropriate referral, and preventive care in primary healthcare settings.

Keywords

• Precocious puberty
• family practice
• primary care physicians
• endocrinology
• awareness

Ethical Statement

This study was conducted after being approved by the Ankara Atatürk Sanatorium Clinical Research Ethics Committee (decision no. 267, dated April 22, 2025).

Birinci Basamakta Puberte Prekoks Konusunda Aile Hekimlerinin Bilgi, Farkındalık ve Yönetim Yaklaşımlarının Değerlendirilmesi

Abstract

Amaç: Puberte prekoks (PP), erken tanı ve uygun yönlendirme gerektiren, sıklığı giderek artan bir klinik durumdur. Bu çalışmanın amacı, birinci basamakta çalışan aile hekimlerinin PP’ye ilişkin tanı, etyoloji, endokrin bozucular, tanısal yaklaşımlar ve tedavi konularındaki bilgi, farkındalık ve tutumlarını değerlendirmek ve klinik eğitimler ile bu parametreler arasındaki ilişkiyi incelemektir.

Gereç ve Yöntemler: Kesitsel ve anket temelli bu çalışmaya, birinci basamakta görev yapan 157 aile hekimi (asistan ve uzman) dâhil edildi. Güncel literatür ve uzman görüşleri doğrultusunda hazırlanan 17 soruluk yapılandırılmış anket ile katılımcıların sosyodemografik özellikleri, PP tanımı ve yaş sınırlarına ilişkin bilgileri, klinik bulguları tanıma düzeyleri, çevresel ve patolojik etyolojik faktörlere yönelik farkındalıkları, Tanner evrelemesini bilme ve klinikte kullanma durumları, tanısal yaklaşımları, yönlendirme eğilimleri ve tedaviye bakış açıları değerlendirildi.

Bulgular: Çalışmaya toplam 157 hekim dâhil edildi; katılımcıların %68,2’si asistan, %31,8’i uzmandı. Hem pediatri hem de çocuk endokrinolojisi rotasyonu yapmış hekimler, kız ve erkek çocuklarda doğru PP yaş sınırlarını daha sık belirledi (sırasıyla p<0,001 ve p=0,022) ve klinik bulgular, nedenler, Tanner evrelemesi, yönlendirme, tetkik isteme ve gonadotropin salgılatıcı hormon analoğu (GnRHa) tedavisinin etkinliği konusunda daha yüksek farkındalık gösterdi (p≤0,006). Asistanlarla karşılaştırıldığında, uzman hekimler şüpheli olguları çocuk endokrinolojisine daha sık yönlendirdi ve GnRHa etkinliğini daha fazla kabul etti; farklılıklar özellikle rotasyon temelli analizlerde belirgindi.

Sonuç: Aile hekimleri PP hakkında temel bilgiye sahip olsalar da, erkeklerde görülen ergenlik bulguları, endokrin bozucu maddeler ve tanı ve tedavi yaklaşımları konusunda farkındalıkta önemli farklılıklar mevcuttur. Pediatri ve pediatrik endokrinoloji alanında yapılandırılmış eğitim, farkındalığın artmasına ve birinci basamak sağlık hizmeti ortamlarında erken teşhis, uygun yönlendirme ve koruyucu bakımın desteklenmesine katkıda bulunabilir.

Keywords

• Puberte prekoks
• aile hekimliği
• birinci basamak hekimleri
• endokrinoloji
• farkındalık

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