Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Portuguese endocrinologists

Puga, F; Simões, Hélder; Melo, Miguel; Attanasio, Roberto; Nagy, Endre; Papini, Enrico; Perros, Petros; Freitas, Cláudia

doi:10.26497/ao210050

Cited by 4 publications

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“…E-MPATHY found significant differences in satisfaction rates between countries, being highest among respondents from Greece and the Philippines and lowest from Northern Europe, which is consistent with reports from physician surveys, 14,[44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] the potential influence of national healthcare systems, socioeconomic and cultural factors. 59 Treatment with L-T4 was associated with a better impact of hypothyroidism on everyday living than L-T4+L-T3 or DTE, which contrasts with a US study.…”

Section: Discussionsupporting

confidence: 77%

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

Nagy

Papini

et al. 2022

Thyroid

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BackgroundHypothyroid patients often report dissatisfaction and poor quality of life. This survey explored the impact of hypothyroidism on patient satisfaction, everyday living, experiences with healthcare professionals and influence of demographic and socioeconomic factors. Methods Cross-sectional questionnaire survey targeting an international population of hypothyroid patients. Multi-level regression modelling was used for analyses. ResultsThe total number of responses was 3915 from 68 countries. Satisfaction with care and treatment was not associated with type of treatment for hypothyroidism. Having no confidence and trust in healthcare professionals was strongly associated with dissatisfaction (p <0.01). Controlling for all other variables, significant differences were found among satisfaction rates between countries. A weak inverse relationship was found between satisfaction with care and treatment and impact on everyday living (p<0.001). Respondents taking levothyroxine alone, Thyroid

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Section: Discussionsupporting

confidence: 77%

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

Nagy

Papini

et al. 2022

Thyroid

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“…In accordance with current international and local guidelines (5,35), and with the results of all the national THESIS studies published so far (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32), LT4 was the treatment of choice for the treatment of hypothyroidism among LATS members.…”

Section: Discussionmentioning

confidence: 60%

“…LATS was invited to participate in an international initiative referred to as THESIS (Treatment of Hypothyroidism in Europe by Specialists an International Survey), which assessed the attitude of experts towards the use of thyroid hormones in hypothyroidism and several euthyroid conditions in 28 countries. So far, 20 national THESIS investigations have been published (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33).…”

Section: Introductionmentioning

confidence: 99%

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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“…One of the study aims was to document the demographic and work-related characteristics of specialists who treat hypothyroid patients in European countries. Twenty out of twenty eight countries surveyed have already reported their national data (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Differences in healthcare delivery may impact the patient experience, and therefore comparisons between regions and countries may provide valuable insights.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of specialists treating hypothyroid patients: the “THESIS” collaborative

Žarković,

Attanasio,

Nagy

et al. 2023

Front. Endocrinol.

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IntroductionThyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors.MethodsThyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS). Geographic regions were defined according to the United Nations Statistics Division. The national economic status was estimated using World Bank data on the gross national income per capita (GNI per capita).Results5,695 valid responses were received (response rate 33·0%). The mean age was 49 years, and 65·0% were female. The proportion of female respondents was lowest in Northern (45·6%) and highest in Eastern Europe (77·2%) (p <0·001). Respondent work volume, university affiliation and private practice differed significantly between countries (p<0·001). Age and GNI per capita were correlated inversely with the proportion of female respondents (p<0·01). GNI per capita was inversely related to the proportion of respondents working exclusively in private practice (p<0·011) and the proportion of respondents who treated >100 patients annually (p<0·01).DiscussionTHESIS has demonstrated differences in characteristics of thyroid specialists at national and regional levels, strongly associated with GNI per capita. Hypothyroid patients in middle-income countries are more likely to encounter female thyroid specialists working in private practice, with a high workload, compared to high-income countries. Whether these differences influence the quality of care and patient satisfaction is unknown, but merits further study.

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Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Portuguese endocrinologists

Cited by 4 publications

References 0 publications

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

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

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

Characteristics of specialists treating hypothyroid patients: the “THESIS” collaborative

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