Management of Primary Hyperparathyroidism: Can We Do Better?
| Autor: | Earl Schuman, Shaghayegh Aliabadi-Wahle, Chet W. Hammill, James R. Carlisle, Ahmed Sharata, Yelena Rozenfeld, Tracy L. Kelly |
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| Rok vydání: | 2017 |
| Předmět: |
Parathyroidectomy
Pediatrics medicine.medical_specialty Retrospective review Younger age endocrine system diseases business.industry medicine.medical_treatment General Medicine Primary care medicine.disease Asymptomatic 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Chart review medicine Hypercalciuria 030212 general & internal medicine medicine.symptom business Primary hyperparathyroidism |
| Zdroj: | The American Surgeon. 83:64-70 |
| ISSN: | 1555-9823 0003-1348 |
| Popis: | The failure to follow national guidelines in management of various diseases has been previously established. We sought to quantify primary care providers’ familiarity with primary hyperparathyroidism as it affects adherence to the 2009 National Institute of Health (NIH) consensus recommendations in treatment of primary hyperparathyroidism. A large primary care group was surveyed to determine their familiarity with the 2009 NIH consensus recommendations for management of primary hyperparathyroidism (PHPT). Retrospective review of the group's records (2009–2011) was performed to verify compliance. Survey responders included 109 clinicians, 31 per cent were familiar with all criteria for surgical intervention in asymptomatic patients and 34 per cent correctly identified appropriate surveillance testing for patients undergoing observation. Chart review identified 124 patients with PHPT. Of the patients who met NIH criteria, 34 per cent had a parathyroidectomy. Younger age, higher intact parathyroid hormone, hypercalciuria, and history of nephrolithiasis were associated with surgery in multivariable analysis. Of the observed patients, 16 per cent had appropriate surveillance studies. In conclusion, this study confirms suboptimal adherence with consensus recommendations in management of PHPT. A minority of clinicians demonstrated solid familiarity with management strategies, paralleling their treatment approach. Educational efforts may improve adherence with upcoming national recommendations. |
| Databáze: | OpenAIRE |
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