OBJECTIVE: To determine whether improvement in quality of life (QoL) in hypopituitary adults with GH deficiency (GHD) receiving long-term growth hormone (GH) replacement therapy is correlated with changes in Patient Reported Outcomes and health care consumption. METHODS: Data were analysed from 196 Swedish hypopituitary adults with GHD who had received 2 years of GH replacement therapy (mean dose, 0.36 mg/day). All patients (95 men, 101 women; mean age at baseline, 51.1 years; range, 27-71 years; were included in KIMS (Pharmacia International Metabolic Database) - a large pharmacoepidemiological survey of adults with GHD. One hundred nineteen (62%) were in full or part-time work, and 29 (15%) had taken early retirement or were receiving a sick benefit. QoL was assessed using AGHDA - a patient-need based, disease-specific questionnaire. Patient Reported Outcomes as general well-being, level and satisfaction with physical activity at leisure time (measured on a visual analogue scales) as well as information on the patients' social situation were obtained using the KIMS Patient Life Situation Form. Days of sick-leave, doctor's visits and hospital visits were recorded as a measure of healthcare resource usage. Patients were divided into four subgroups depending on the level of improvement in QoL 1) No or deterioration QoL (n=52); 2) Moderate (n=44); 3) Essential (n=37); and 4) Excellent (n=39). Statistical analysis was done with linear and logistic regression. Adjustments were done for age and sex. RESULTS: Increased level and satisfaction of physical activity as well as well being were significantly associated with improvements in QoL (p<0.003). Although healthcare consumption decreased significantly during treatment, any clear association with improvements in QoL was not found. CONCLUSIONS: The improved QoL in GH-replaced hypopituitary adults with GHD is significantly related to their change in general well-being and leisure-time activity, whereas the change in healthcare consumption does not show the same pattern.