Thyroid dysfunction in patients older than 75 years: an analysis of inadequacy of treatment and therapeutic control

Díez, Juan J.; Iglesias, Pedro; García, Agustin A.; Mataix, Ángel; Andreu, Francisco A. Bernabéu

doi:10.1007/s41999-021-00544-x

Cited by 5 publications

(3 citation statements)

References 43 publications

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“…The present BDCAP data show that the proportion of hypothyroid patients with TSH > 4.0 mU/l (suggesting undertreatment) clearly rises between the age groups of 65-69 years and 90 years and older. This finding is in line with results of the previously mentioned study [15] that showed that, indeed, the frequency of inadequate control of thyroid dysfunction was higher in patients aged 82 years or older compared to those aged 75 to 81 years.…”

Section: Discussionsupporting

confidence: 92%

“…A recent study by our group conducted in outpatients over 75 years of age showed that 39.7% and 27.5% of patients with low and high levels, respectively, of TSH were inadequately treated. The main causes for inadequacy were the inappropriate prescription of levothyroxine and antithyroid medication 15 . The present BDCAP data show that the proportion of hypothyroid patients with TSH>4.0 mU/l (suggesting undertreatment) clearly rises between the age groups of 65–69 years and 90 years and older.…”

Section: Discussionmentioning

confidence: 99%

“…This large database allows us to study large population groups with a sample size that would be impossible to achieve through routine clinical studies. For this reason and given that there are very few studies in Spain that have dealt with analyzing the degree of control of people treated for hypothyroidism and hyperthyroidism [15], it seemed appropriate to use this public database to obtain clinically relevant information. Our aim has been to estimate the proportion of subjects with serum TSH values outside the reference interval in a large cohort of patients with hypothyroidism and hyperthyroidism undergoing treatment for thyroid dysfunction in Spain using available information in BDCAP.…”

Section: Introductionmentioning

confidence: 99%

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Control of Thyroid Dysfunction in Spanish Population Registered in the Primary Care Clinical Database: An Analysis of the Proportion of Patients with Thyrotropin Values Outside the Reference Range

Díez

Iglesias

2023

Horm Metab Res

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Inadequate control of thyroid dysfunction is common and has deleterious health consequences. Our objective was to determine the prevalence of TSH values outside the reference range, as an indicator of inadequate control of hypothyroidism and hyperthyroidism in patients undergoing treatment for thyroid dysfunction in Spain. An observational, retrospective, non-interventional study was conducted using the Primary Care Clinical Database (BDCAP). Patients treated with thyroid hormone for hypothyroidism and with antithyroid drugs for hyperthyroidism were identified. We assessed serum TSH concentration, considering values from 0.4 to 4.0 mU/l as the reference interval. We found 360 313 people with hypothyroidism on thyroid hormone replacement and 9239 with hyperthyroidism on antithyroid drugs therapy. TSH values outside the reference range in hypothyroid subject were detected in 126 866 (35.20%) people, of whom 107 205 (29.75%) had TSH>4.0 mU/l, suggesting inappropriately low doses of levothyroxine, and 19 661 (5.46%) had TSH<0.4 mU/l, suggesting inappropriate over replacement. In the hyperthyroid group, TSH values outside the reference range were observed in 4252 (46.02%) patients. There were 2833 (30.66%) patients with TSH<0.4 mU/l, suggesting undertreatment, and 1419 (15.36%) with TSH>4.0 mU/l, suggesting overtreatment with antithyroid medication. People over 65 years of age had a lower frequency of undertreatment of hypothyroidism and a lower frequency of overtreatment and undertreatment of hyperthyroidism. In conclusion, our results suggest that inadequate control of thyroid dysfunction, due to its high frequency and its consequences for health, is a public health problem that should be addressed by clinicians and health authorities.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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