Patients' Persistent Symptoms, Clinician Demographics, and Geo-Economic Factors Are Associated with Choice of Therapy for Hypothyroidism by European Thyroid Specialists: The "THESIS" Collaboration
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články
PubMed
38368541
DOI
10.1089/thy.2023.0580
Knihovny.cz E-zdroje
- Klíčová slova
- geo-economics, hypothyroidism, levothyroxine, quality of life, survey, triiodothyronine,
- MeSH
- demografie MeSH
- hypotyreóza * farmakoterapie epidemiologie MeSH
- lidé MeSH
- thyreotropin * MeSH
- thyroxin MeSH
- trijodthyronin MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- thyreotropin * MeSH
- thyroxin MeSH
- trijodthyronin 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
Citace poskytuje Crossref.org
Treatment of Obesity with Thyroid hormones in Europe. Data from the THESIS* Collaboration
