-
Something wrong with this record ?
Patients' Persistent Symptoms, Clinician Demographics, and Geo-Economic Factors Are Associated with Choice of Therapy for Hypothyroidism by European Thyroid Specialists: The "THESIS" Collaboration
R. Attanasio, M. Žarković, E. Papini, EV. Nagy, R. Negro, P. Perros, E. Akarsu, M. Alevizaki, G. Ayvaz, T. Bednarczuk, BN. Beleslin, E. Berta, M. Bodor, AM. Borissova, M. Boyanov, C. Buffet, MC. Burlacu, J. Ćirić, JJ. Díez, H. Dobnig, V. Fadeyev,...
Language English Country United States
Document type Journal Article
PubMed
38368541
DOI
10.1089/thy.2023.0580
Knihovny.cz E-resources
- MeSH
- Demography MeSH
- Hypothyroidism * drug therapy epidemiology MeSH
- Humans MeSH
- Thyrotropin * MeSH
- Thyroxine MeSH
- Triiodothyronine MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Background: Hypothyroidism is common, however, aspects of its treatment remain controversial. Our survey aimed at documenting treatment choices of European thyroid specialists and exploring how patients' persistent symptoms, clinician demographics, and geo-economic factors relate to treatment choices. Methods: Seventeen thousand two hundred forty-seven thyroid specialists from 28 countries were invited to participate in an online questionnaire survey. The survey included respondent demographic data and treatment choices for hypothyroid patients with persistent symptoms. Geo-economic data for each country were included in the analyses. Results: The response rate was 32.9% (6058 respondents out of 17,247 invitees). Levothyroxine (LT4) was the initial treatment preferred by the majority (98.3%). Persistent symptoms despite normal serum thyrotropin (TSH) while receiving LT4 treatment were reported to affect up to 10.0% of patients by 75.4% of respondents, while 28.4% reported an increasing such trend in the past 5 years. The principal explanations offered for patients' persistent symptoms were psychosocial factors (77.1%), comorbidities (69.2%), and unrealistic patient expectations (61.0%). Combination treatment with LT4+liothyronine (LT3) was chosen by 40.0% of respondents for patients who complained of persistent symptoms despite a normal TSH. This option was selected more frequently by female thyroid specialists, with high-volume practice, working in countries with high gross national income per capita. Conclusions: The perception of patients' dissatisfaction reported by physicians seems lower than that described by hypothyroid patients in previous surveys. LT4+LT3 treatment is used frequently by thyroid specialists in Europe for persistent hypothyroid-like symptoms even if they generally attribute such symptoms to nonendocrine causes and despite the evidence of nonsuperiority of the combined over the LT4 therapy. Pressure by dissatisfied patients on their physicians for LT3-containing treatments is a likely explanation. The association of the therapeutic choices with the clinician demographic characteristics and geo-economic factors in Europe is a novel information and requires further investigation.
Cabinet Médical 2 Lausanne Switzerland
Clinic of Endocrinology and Metabolism University Hospital Alexandrovska Sofia Bulgaria
Department of Endocrinology and Diabetes Centre Hellenic Red Cross Hospital Athens Greece
Department of Endocrinology and Metabolism Koru Ankara Hospital Çankaya Turkey
Department of Endocrinology and Metabolism Regina Apostolorum Hospital Rome Italy
Department of Endocrinology Belarusian State Medical University Minsk Republic of Belarus
Department of Endocrinology Carol Davila University of Medicine and Pharmacy Bucharest Romania
Department of Endocrinology Clínica Universidad de Navarra Pamplona Spain
Department of Endocrinology Hospital Universitario Puerta de Hierro Majadahonda Madrid Spain
Department of Endocrinology Odense University Hospital Odense C Denmark
Department of Endocrinology Skåne University Hospital Malmö Sweden
Department of Endocrinology Tampere University Hospital Tampere Finland
Department of Internal Medicine and Endocrinology Medical University of Warsaw Warsaw Poland
Department of Internal Medicine Medical University Sofia Sofia Bulgaria
Department of Medicine Universidad Autónoma de Madrid Madrid Spain
Department of Surgery Tampere University Hospital Tampere Finland
Diabetes and Endocrinology Section Beacon Hospital Dublin Ireland
Division of Endocrinology Diabetes and Metabolism University of Lausanne Lausanne Switzerland
Division of Endocrinology Ospedale Fazzi Lecce Italy
East Surrey Hospital Surrey and Sussex Healthcare NHS Trust Redhill United Kingdom
Instituto de Investigación Sanitaria de Navarra Pamplona Spain
Robert Graves Institute Tallaght University Hospital Dublin Ireland
School of Medicine University College Dublin Dublin Ireland
Scientific Committee Associazione Medici Endocrinologi Milan Italy
References provided by Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc24014474
- 003
- CZ-PrNML
- 005
- 20240905133551.0
- 007
- ta
- 008
- 240725s2024 xxu f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1089/thy.2023.0580 $2 doi
- 035 __
- $a (PubMed)38368541
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a xxu
- 100 1_
- $a Attanasio, Roberto $u Scientific Committee Associazione Medici Endocrinologi, Milan, Italy $1 https://orcid.org/000000021417287X
- 245 10
- $a Patients' Persistent Symptoms, Clinician Demographics, and Geo-Economic Factors Are Associated with Choice of Therapy for Hypothyroidism by European Thyroid Specialists: The "THESIS" Collaboration / $c R. Attanasio, M. Žarković, E. Papini, EV. Nagy, R. Negro, P. Perros, E. Akarsu, M. Alevizaki, G. Ayvaz, T. Bednarczuk, BN. Beleslin, E. Berta, M. Bodor, AM. Borissova, M. Boyanov, C. Buffet, MC. Burlacu, J. Ćirić, JJ. Díez, H. Dobnig, V. Fadeyev, BCT. Field, E. Fliers, D. Führer-Sakel, JC. Galofré, T. Hakala, J. Jiskra, PA. Kopp, M. Krebs, M. Kršek, M. Kužma, M. Lantz, I. Lazúrová, L. Leenhardt, V. Luchytskiy, F. Marques Puga, A. McGowan, S. Metso, C. Moran, T. Morgunova, DA. Niculescu, B. Perić, T. Planck, C. Poiana, E. Robenshtok, PO. Rosselet, M. Ruchala, K. Ryom Riis, A. Shepelkevich, MD. Tronko, D. Unuane, I. Vardarli, WE. Visser, A. Vryonidou, YR. Younes, L. Hegedüs
- 520 9_
- $a Background: Hypothyroidism is common, however, aspects of its treatment remain controversial. Our survey aimed at documenting treatment choices of European thyroid specialists and exploring how patients' persistent symptoms, clinician demographics, and geo-economic factors relate to treatment choices. Methods: Seventeen thousand two hundred forty-seven thyroid specialists from 28 countries were invited to participate in an online questionnaire survey. The survey included respondent demographic data and treatment choices for hypothyroid patients with persistent symptoms. Geo-economic data for each country were included in the analyses. Results: The response rate was 32.9% (6058 respondents out of 17,247 invitees). Levothyroxine (LT4) was the initial treatment preferred by the majority (98.3%). Persistent symptoms despite normal serum thyrotropin (TSH) while receiving LT4 treatment were reported to affect up to 10.0% of patients by 75.4% of respondents, while 28.4% reported an increasing such trend in the past 5 years. The principal explanations offered for patients' persistent symptoms were psychosocial factors (77.1%), comorbidities (69.2%), and unrealistic patient expectations (61.0%). Combination treatment with LT4+liothyronine (LT3) was chosen by 40.0% of respondents for patients who complained of persistent symptoms despite a normal TSH. This option was selected more frequently by female thyroid specialists, with high-volume practice, working in countries with high gross national income per capita. Conclusions: The perception of patients' dissatisfaction reported by physicians seems lower than that described by hypothyroid patients in previous surveys. LT4+LT3 treatment is used frequently by thyroid specialists in Europe for persistent hypothyroid-like symptoms even if they generally attribute such symptoms to nonendocrine causes and despite the evidence of nonsuperiority of the combined over the LT4 therapy. Pressure by dissatisfied patients on their physicians for LT3-containing treatments is a likely explanation. The association of the therapeutic choices with the clinician demographic characteristics and geo-economic factors in Europe is a novel information and requires further investigation.
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 12
- $a thyreotropin $7 D013972
- 650 12
- $a hypotyreóza $x farmakoterapie $x epidemiologie $7 D007037
- 650 _2
- $a thyroxin $7 D013974
- 650 _2
- $a trijodthyronin $7 D014284
- 650 _2
- $a demografie $7 D003710
- 655 _2
- $a časopisecké články $7 D016428
- 700 1_
- $a Žarković, Miloš $u Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia $1 https://orcid.org/0000000199775970
- 700 1_
- $a Papini, Enrico $u Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Rome, Italy $1 https://orcid.org/0000000347902733
- 700 1_
- $a Nagy, Endre Vezekenyi $u Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary $1 https://orcid.org/0000000292866471
- 700 1_
- $a Negro, Roberto $u Division of Endocrinology, Ospedale Fazzi, Lecce, Italy $1 https://orcid.org/0000000192824530
- 700 1_
- $a Perros, Petros $u Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, United Kingdom $1 https://orcid.org/0000000173205574
- 700 1_
- $a Akarsu, Ersin $u Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey $1 https://orcid.org/0000000327866616
- 700 1_
- $a Alevizaki, Maria $u Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece $1 https://orcid.org/0000000337265793
- 700 1_
- $a Ayvaz, Göksun $u Department of Endocrinology and Metabolism, Koru Ankara Hospital, Çankaya, Turkey $1 https://orcid.org/000000212136832
- 700 1_
- $a Bednarczuk, Tomasz $u Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland $1 https://orcid.org/0000000257528709
- 700 1_
- $a Beleslin, Biljana Nedeljković $u Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia $1 https://orcid.org/0000000216879297
- 700 1_
- $a Berta, Eszter $u Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary $1 https://orcid.org/0000000304399867
- 700 1_
- $a Bodor, Miklos $u Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary $1 https://orcid.org/0000000207895156
- 700 1_
- $a Borissova, Anna Maria $u Clinic of Endocrinology and Metabolism, University Hospital "Sofiamed," Medical Faculty, Sofia University "Saint Kliment Ohridski," Sofia, Bulgaria $1 https://orcid.org/000000030553408X
- 700 1_
- $a Boyanov, Mihail $u Clinic of Endocrinology and Metabolism, University Hospital "Alexandrovska," Sofia, Bulgaria $u Department of Internal Medicine, Medical University Sofia, Sofia, Bulgaria $1 https://orcid.org/0000000256952831
- 700 1_
- $a Buffet, Camille $u GRC n 16, GRC Thyroid Tumors, Thyroid Disease and Endocrine Tumor Department, APHP, Hôpital Pitié-Salpêtriére, Sorbonne Universitè, Paris, France $1 https://orcid.org/0000000313894157
- 700 1_
- $a Burlacu, Maria-Cristina $u Department of Endocrinology Diabetology and Nutrition, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium $1 https://orcid.org/0000000284373933
- 700 1_
- $a Ćirić, Jasmina $u Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia $1 https://orcid.org/0000000169609699
- 700 1_
- $a Díez, Juan J $u Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain $u Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Calle Manuel de Falla, Madrid, Spain $u Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain $1 https://orcid.org/0000000259413489
- 700 1_
- $a Dobnig, Harald $u Thyroid and Osteoporosis Praxis, Kumberg, Austria $u Thyroid Practice for Radiofrequency Ablation, Vienna, Austria
- 700 1_
- $a Fadeyev, Valentin $u Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation $1 https://orcid.org/0000000230266315
- 700 1_
- $a Field, Benjamin C T $u Section of Clinical Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom $1 https://orcid.org/0000000218831588
- 700 1_
- $a Fliers, Eric $u Department of Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands $1 https://orcid.org/0000000180489050
- 700 1_
- $a Führer-Sakel, Dagmar $u Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany $1 https://orcid.org/0000000303574192
- 700 1_
- $a Galofré, Juan Carlos $u Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Spain $u Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain $1 https://orcid.org/0000000302273566
- 700 1_
- $a Hakala, Tommi $u Department of Surgery, Tampere University Hospital, Tampere, Finland $1 https://orcid.org/0000000293734462
- 700 1_
- $a Jiskra, Jan $u 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic $1 https://orcid.org/0000000309204854 $7 xx0061811
- 700 1_
- $a Kopp, Peter A $u Division of Endocrinology, Diabetes and Metabolism, University of Lausanne, Lausanne, Switzerland $1 https://orcid.org/0000000159800529
- 700 1_
- $a Krebs, Michael $u Division of Endocrinology and Metabolism, Internal Medicine III, Medical University of Vienna, Vienna, Austria $1 https://orcid.org/0000000292657274
- 700 1_
- $a Kršek, Michal $u 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
- 700 1_
- $a Kužma, Martin $u 5th Department of Internal Medicine, Medical Faculty of Comenius University and University Hospital, Bratislava, Slovakia $1 https://orcid.org/0000000212941217
- 700 1_
- $a Lantz, Mikael $u Department of Endocrinology, Skåne University Hospital, Malmö, Sweden $1 https://orcid.org/0000000334459090
- 700 1_
- $a Lazúrová, Ivica $u 1st Department of Internal Medicine of the Medical Faculty, P.J. Šafárik University Košice, Košice, Slovakia $1 https://orcid.org/0000000231631097
- 700 1_
- $a Leenhardt, Laurence $u GRC n 16, GRC Thyroid Tumors, Thyroid Disease and Endocrine Tumor Department, APHP, Hôpital Pitié-Salpêtriére, Sorbonne Universitè, Paris, France $1 https://orcid.org/0000000341316813
- 700 1_
- $a Luchytskiy, Vitaliy $u Department of Reproductive Endocrinology, Institute of Endocrinology and Metabolism named after V.P. Komissarenko, National Academy of Medical Science of Ukraine, Kyiv, Ukraine $1 https://orcid.org/0000000235153264
- 700 1_
- $a Marques Puga, Francisca $u Endocrinology, Diabetes and Metabolism Service, Centro Hospitalar Universitário de Santo António, Porto, Portugal $1 https://orcid.org/000000029510419X
- 700 1_
- $a McGowan, Anne $u Robert Graves Institute, Tallaght University Hospital, Dublin, Ireland $1 https://orcid.org/000000034222622X
- 700 1_
- $a Metso, Saara $u Department of Endocrinology, Tampere University Hospital, Tampere, Finland $1 https://orcid.org/0000000181977603
- 700 1_
- $a Moran, Carla $u Diabetes & Endocrinology Section, Beacon Hospital, Dublin, Ireland $u School of Medicine, University College Dublin, Dublin, Ireland $1 https://orcid.org/0000000273187166
- 700 1_
- $a Morgunova, Tatyana $u Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation $1 https://orcid.org/0000000315001586
- 700 1_
- $a Niculescu, Dan Alexandru $u Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania $1 https://orcid.org/0000000264393523
- 700 1_
- $a Perić, Božidar $u Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso," University Hospital Center "Sisters of Mercy," Zagreb, Croatia $1 https://orcid.org/0000000199984895
- 700 1_
- $a Planck, Tereza $u Department of Endocrinology, Skåne University Hospital, Malmö, Sweden $1 https://orcid.org/0000000313985067
- 700 1_
- $a Poiana, Catalina $u Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania $1 https://orcid.org/0000000257953318
- 700 1_
- $a Robenshtok, Eyal $u Thyroid Cancer Service, Endocrinology and Metabolism Institute, Beilinson Hospital and Davidoff Cancer Center, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel $1 https://orcid.org/0000000262684212
- 700 1_
- $a Rosselet, Patrick Olivier $u Cabinet Médical 2, Lausanne, Switzerland $1 https://orcid.org/0009000437938163
- 700 1_
- $a Ruchala, Marek $u Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland $1 https://orcid.org/0000000262967220
- 700 1_
- $a Ryom Riis, Kamilla $u Department of Endocrinology, Odense University Hospital, Odense C, Denmark $1 https://orcid.org/0000000326797153
- 700 1_
- $a Shepelkevich, Alla $u Department of Endocrinology, Belarusian State Medical University, Minsk, Republic of Belarus $1 https://orcid.org/0000000282132968
- 700 1_
- $a Tronko, Mykola D $u V.P. Komisarenko Institute of Endocrinology and Metabolism of Academy of Medical Sciences of Ukraine, Kyiv, Ukraine $1 https://orcid.org/0000000174210981
- 700 1_
- $a Unuane, David $u Department of Internal Medicine, Endocrine Unit, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium $1 https://orcid.org/0000000284881735
- 700 1_
- $a Vardarli, Irfan $u Department of Medicine I, Klinikum Vest GmbH, Knappschaftskrankenhaus Recklinghausen, Academic Teaching Hospital, Ruhr-University Bochum, Recklinghausen, Germany $u Division of Endocrinology and Diabetes, 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany $1 https://orcid.org/0009000925540971
- 700 1_
- $a Visser, W Edward $u Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands $1 https://orcid.org/000000025248863X
- 700 1_
- $a Vryonidou, Andromachi $u Department of Endocrinology and Diabetes Centre, Hellenic Red Cross Hospital, Athens, Greece $1 https://orcid.org/0000000205445952
- 700 1_
- $a Younes, Younes Ramazan $u East Surrey Hospital, Surrey & Sussex Healthcare NHS Trust, Redhill, United Kingdom $1 https://orcid.org/0000000309291003
- 700 1_
- $a Hegedüs, Laszlo $u Department of Endocrinology, Odense University Hospital, Odense C, Denmark $1 https://orcid.org/0000000296917619
- 773 0_
- $w MED00004519 $t Thyroid $x 1557-9077 $g Roč. 34, č. 4 (2024), s. 429-441
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/38368541 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y - $z 0
- 990 __
- $a 20240725 $b ABA008
- 991 __
- $a 20240905133545 $b ABA008
- 999 __
- $a ok $b bmc $g 2143931 $s 1226340
- BAS __
- $a 3
- BAS __
- $a PreBMC-MEDLINE
- BMC __
- $a 2024 $b 34 $c 4 $d 429-441 $e 20240322 $i 1557-9077 $m Thyroid $n Thyroid $x MED00004519
- LZP __
- $a Pubmed-20240725
