The Impact of Hypothyroidism on Satisfaction with Care and Treatment and Everyday Living: Results from E-Mode Patient Self-Assessment of Thyroid Therapy, a Cross-Sectional, International Online Patient Survey

Perros, Petros; Nagy, Endre; Papini, Enrico; Hay, Harriet; Abad-Madroñero, Juan; Tallett, Amy; Bilas, Megan; Lakwijk, Peter; Poots, Alan J

doi:10.1089/thy.2022.0324

Cited by 14 publications

(15 citation statements)

References 63 publications

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“…LATS members, in accord with other national THESIS investigations, indicated that the most common reasons for persistent symptoms in hypothyroid patients, despite normalization of TSH were comorbidities, psychosocial factors, and unrealistic patient´s expectations, rather than inability of LT4 to restore normal physiology. This impression is supported by a recent patient survey, which found a strong correlation between patient dissatisfaction with treatment and care and mistrust in healthcare professionals, while LT4 treatment (compared to LT3-containing regimens) was associated with a positive impact on daily living (42). In addition, a high prevalence of somatization was noted among hypothyroid patients and a tendency to attribute all persistent symptoms to hypothyroidism or its treatment (43), implying that personality traits may in uence the propensity of hypothyroid patients being dissatis ed with thyroid hormone treatment.…”

Section: Persistent Symptoms In Lt-4 Patientsmentioning

confidence: 81%

Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS)

Cassemiro,

Ilera,

Batalles

et al. 2023

Preprint

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Purpose: Inconsistencies in the medical management of hypothyroidism have been reported between endocrinologists in different countries. This study aimed to identify the attitudes of Latin America thyroid specialists towards the use of thyroid hormones. Methods: Online survey of members of the Latin America Thyroid Society. Results:81/446 (18.2%) completed the questionnaire. Levothyroxine (LT4) was the initial treatment of choice for all respondents. 56.8% would consider LT4 use in biochemically euthyroid patients: infertile women with elevated anti-thyroid antibodies (46.9%), resistant depression (17.3%) and growing goiter (12%). Most respondents preferred tablets (39.5%) over liquid formulations (21.0%) or soft gel capsules (22.2%) and would not consider switching formulations in patients with persistent symptoms. 39.5% would never use LT4+liothyronine (LT3) combination therapy in symptomatic euthyroid patients, due to low quality evidence for benefit. 60.5% reported that persistence of symptoms despite normal TSH is rare (below 5% of patients) and its prevalence has been stable over the last five years. Psychosocial factors (84.0%), comorbidities (86.4%) and the patient unrealistic expectation (72.8%) were considered the top three explanations for this phenomenon. Conclusion:LT4 tablets is the treatment of choice for hypothyroidism. A significant proportion of respondents would use LT4 in some groups of euthyroid individuals, contrasting the recommendations of the major clinical practice guideline indications. LT4+LT3 combination treatment in euthyroid symptomatic patients was considered by nearly 50%. Practices based on weak or absent evidence included use of thyroid hormones for euthyroid subjects by 56.8% of respondents and use of LT4 +LT3 treatment by 60.5% of respondents for patients with persistent symptoms. In contrast to many European countries, LATS respondents report a low and unchanged proportion of dissatisfied patients over the last five years.

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Section: Persistent Symptoms In Lt-4 Patientsmentioning

confidence: 81%

Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS)

Cassemiro,

Ilera,

Batalles

et al. 2023

Preprint

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“…Many questions regarding the treatment of patients with hypothyroidism with adequate biochemical control but ongoing symptoms remain including the benefits and risks of LT3 + LT4 combination therapy. Further research in this area, including that of nonmedication related factors, 27 will help guide management of a very common condition and allow us to avoid low value treatments.…”

Section: Discussionmentioning

confidence: 99%

“…These beliefs appear to be consistent with surveys of endocrinologists in other countries across the world suggesting that many endocrinologists do not believe that different preparations are likely to benefit symptomatic patients. 12,13,15,16,18,22,25 A recent international patient questionnaire has highlighted the discord between the views of patients and physicians regarding reasons for dissatisfaction with treatment, 26 but also that dissatisfaction is significantly associated with patients' personality traits. 27 However, many continue to prescribe LT3 + LT4 combination therapy for this group.…”

Section: Use Of Combination Lt3/lt4 Therapymentioning

confidence: 99%

“…12,13,15,16,18,22,25 A recent international patient questionnaire has highlighted the discord between the views of patients and physicians regarding reasons for dissatisfaction with treatment, 26 but also that dissatisfaction is significantly associated with patients' personality traits. 27 However, many continue to prescribe LT3 + LT4 combination therapy for this group. It is likely that this group represents a heterogenous group of patients and many of the reasons listed above may apply to different subgroup of patients and treatment of the appropriate cause is critical.…”

Section: Use Of Combination Lt3/lt4 Therapymentioning

confidence: 99%

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Use of thyroid hormones in hypothyroid and euthyroid patients: A survey of members of the Endocrine Society of Australia

Lafontaine,

Brown,

Perros

et al. 2024

Clinical Endocrinology

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ObjectiveHypothyroidism is a common endocrine condition usually managed with levothyroxine (LT4). However, controversy remains around the use of liothyronine (LT3). We aimed to investigate the practices of Australian endocrinologists when managing patients with hypothyroidism, their use of LT3 + LT4 combination therapy and use of thyroid hormones in euthyroid patients.Design and ParticipantsMembers of the Endocrine Society of Australia (ESA) were invited to participate in an online questionnaire.MeasurementsWe analysed questionnaires that had complete demographic data.ResultsEighty‐seven questionnaires fulfilled the criteria. LT4 was used as first line treatment for hypothyroidism by all respondents. Only 45% reported that their patients were dispensed the brand of LT4 that they recommend. LT3 (alone or in combination) was prescribed by 44% in their clinical practice. Although 49% of respondents would consider LT3 + LT4 in patients with normal TSH who had ongoing symptoms of hypothyroidism, the inability of LT4 to restore normal physiology was ranked the least likely explanation for persistent symptoms and only 32% would consider it for themselves if they were diagnosed with hypothyroidism. The majority (55%), in accordance with evidence, would not prescribe thyroid hormone to euthyroid individuals but 39% would consider use in euthyroid female infertility with high levels of thyroid antibodies and 11% in euthyroid patients with a simple goitre growing over time. LT4 use in pregnancy was variable among members.ConclusionsAustralian endocrinologists mostly follow international guidelines when prescribing thyroid hormone therapy and many prescribe combination LT3 and LT4 therapy, particularly for patients who remain symptomatic on LT4 monotherapy. Prescribing practices are largely similar to other countries who have completed similar questionnaires.

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“…Lastly, 10-15% of hy-T patients voice their discontent because of L-T4 treatment outcomes [23,24]. In fact, this recent evidence urges to involve in the care of hy-T above all hy-T patients themselves [25,26]. 2023 Recruiting * NA: not available; Data taken from reference [47].…”

Section: Introductionmentioning

confidence: 99%

Medical Applications of Molecular Biotechnologies in the Context of the Hashimoto’s Thyroiditis

Trovato¹,

Valenti²

2023

Preprint

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Hashimoto’s thyroiditis (HT) is a gender autoimmune disease that is manifested by chronic inflammation of thyroid. Clinical trial studies (CTSs) use molecular biotechnologies (MB) to approach HT appearance. Aims of this study was to analyze the applications of MB in CTSs carried out in HT populations (HT-CTSs). Further, to evaluate the role of MB in the context of hygiene hypothesis (HH). From 75 HT-CTSs found at https://beta.clinicaltrials.gov/ web place, forty-five were considered for this investigation. Finally, six HT-CTSs were reported as molecular HT-CTSs (mHT-CTSs) because of these were planning to utilize MB. Two of mHT-CTSs were settled on French population to isolate DNA viral sequences. Blood, urine, and thyroid tissues biospecimens were analyzed to pick out parvo and polyoma viruses. Two mHT-CTSs carried out in China, were aimed to identify oral and fecal microbiotas by measuring PCR sequencing of 16S rRNA gene. Two mHT-CTSs were programmed in USA and Greece, respectively, for interception of DNA polymorphisms to associate with genetic susceptibility to HT. In conclusion, MB are mainly employed in HT-CTSs for infective pathogenesis and genetic fingerprinting of HT. Besides, MB don't prove the evidence of HH; however, they are useful for direct evidence of the presence of viruses.

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The Impact of Hypothyroidism on Satisfaction with Care and Treatment and Everyday Living: Results from E-Mode Patient Self-Assessment of Thyroid Therapy, a Cross-Sectional, International Online Patient Survey

Cited by 14 publications

References 63 publications

Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS)

Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS)

Use of thyroid hormones in hypothyroid and euthyroid patients: A survey of members of the Endocrine Society of Australia

Medical Applications of Molecular Biotechnologies in the Context of the Hashimoto’s Thyroiditis

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