Patients' Persistent Symptoms, Clinician Demographics, and Geo-Economic Factors Are Associated with Choice of Therapy for Hypothyroidism by European Thyroid Specialists: The "THESIS" Collaboration.

Autor: Attanasio R; Scientific Committee Associazione Medici Endocrinologi, Milan, Italy., Žarković M; Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Papini E; Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Rome, Italy., Nagy EV; Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Negro R; Division of Endocrinology, Ospedale Fazzi, Lecce, Italy., Perros P; Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, United Kingdom., Akarsu E; Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey., Alevizaki M; Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece., Ayvaz G; Department of Endocrinology and Metabolism, Koru Ankara Hospital, Çankaya, Turkey., Bednarczuk T; Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland., Beleslin BN; Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Berta E; Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Bodor M; Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Borissova AM; Clinic of Endocrinology and Metabolism, University Hospital 'Sofiamed,' Medical Faculty, Sofia University 'Saint Kliment Ohridski,' Sofia, Bulgaria., Boyanov M; Clinic of Endocrinology and Metabolism, University Hospital 'Alexandrovska,' Sofia, Bulgaria.; Department of Internal Medicine, Medical University Sofia, Sofia, Bulgaria., Buffet C; GRC n 16, GRC Thyroid Tumors, Thyroid Disease and Endocrine Tumor Department, APHP, Hôpital Pitié-Salpêtriére, Sorbonne Universitè, Paris, France., Burlacu MC; Department of Endocrinology Diabetology and Nutrition, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium., Ćirić J; Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Thyroid Department, Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Díez JJ; Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Calle Manuel de Falla, Madrid, Spain.; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain., Dobnig H; Thyroid and Osteoporosis Praxis, Kumberg, Austria.; Thyroid Practice for Radiofrequency Ablation, Vienna, Austria., Fadeyev V; Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation., Field BCT; Section of Clinical Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom., Fliers E; Department of Endocrinology & Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Führer-Sakel D; Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany., Galofré JC; Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Spain.; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain., Hakala T; Department of Surgery, Tampere University Hospital, Tampere, Finland., Jiskra J; 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic., Kopp PA; Division of Endocrinology, Diabetes and Metabolism, University of Lausanne, Lausanne, Switzerland., Krebs M; Division of Endocrinology and Metabolism, Internal Medicine III, Medical University of Vienna, Vienna, Austria., Kršek M; 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic., Kužma M; 5th Department of Internal Medicine, Medical Faculty of Comenius University and University Hospital, Bratislava, Slovakia., Lantz M; Department of Endocrinology, Skåne University Hospital, Malmö, Sweden., Lazúrová I; 1st Department of Internal Medicine of the Medical Faculty, P.J. Šafárik University Košice, Košice, Slovakia., Leenhardt L; GRC n 16, GRC Thyroid Tumors, Thyroid Disease and Endocrine Tumor Department, APHP, Hôpital Pitié-Salpêtriére, Sorbonne Universitè, Paris, France., Luchytskiy V; Department of Reproductive Endocrinology, Institute of Endocrinology and Metabolism named after V.P. Komissarenko, National Academy of Medical Science of Ukraine, Kyiv, Ukraine., Marques Puga F; Endocrinology, Diabetes and Metabolism Service, Centro Hospitalar Universitário de Santo António, Porto, Portugal., McGowan A; Robert Graves Institute, Tallaght University Hospital, Dublin, Ireland., Metso S; Department of Endocrinology, Tampere University Hospital, Tampere, Finland., Moran C; Diabetes & Endocrinology Section, Beacon Hospital, Dublin, Ireland.; School of Medicine, University College Dublin, Dublin, Ireland., Morgunova T; Department of Endocrinology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation., Niculescu DA; Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania., Perić B; Department of Endocrinology, Diabetes and Metabolic Diseases 'Mladen Sekso,' University Hospital Center 'Sisters of Mercy,' Zagreb, Croatia., Planck T; Department of Endocrinology, Skåne University Hospital, Malmö, Sweden., Poiana C; Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania., Robenshtok E; 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., Rosselet PO; Cabinet Médical 2, Lausanne, Switzerland., Ruchala M; Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland., Ryom Riis K; Department of Endocrinology, Odense University Hospital, Odense C, Denmark., Shepelkevich A; Department of Endocrinology, Belarusian State Medical University, Minsk, Republic of Belarus., Tronko MD; V.P. Komisarenko Institute of Endocrinology and Metabolism of Academy of Medical Sciences of Ukraine, Kyiv, Ukraine., Unuane D; Department of Internal Medicine, Endocrine Unit, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium., Vardarli I; Department of Medicine I, Klinikum Vest GmbH, Knappschaftskrankenhaus Recklinghausen, Academic Teaching Hospital, Ruhr-University Bochum, Recklinghausen, Germany.; Division of Endocrinology and Diabetes, 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany., Visser WE; Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands., Vryonidou A; Department of Endocrinology and Diabetes Centre, Hellenic Red Cross Hospital, Athens, Greece., Younes YR; East Surrey Hospital, Surrey & Sussex Healthcare NHS Trust, Redhill, United Kingdom., Hegedüs L; Department of Endocrinology, Odense University Hospital, Odense C, Denmark.
Jazyk: angličtina
Zdroj: Thyroid : official journal of the American Thyroid Association [Thyroid] 2024 Apr; Vol. 34 (4), pp. 429-441. Date of Electronic Publication: 2024 Mar 22.
DOI: 10.1089/thy.2023.0580
Abstrakt: 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.
Databáze: MEDLINE