Dataset Information

Characteristics of specialists treating hypothyroid patients: the "THESIS" collaborative.

ABSTRACT:

Introduction

Thyroid 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.

Methods

Thyroid 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).

Results

5,695 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).

Discussion

THESIS 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.

SUBMITTER: Zarkovic M

PROVIDER: S-EPMC10660282 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Characteristics of specialists treating hypothyroid patients: the "THESIS" collaborative.

Žarković Miloš M Attanasio Roberto R Nagy Endre V EV Negro Roberto R Papini Enrico E Perros Petros P Cohen Chagit Adler CA Akarsu Ersin E Alevizaki Maria M Ayvaz Göksun G Bednarczuk Tomasz T Berta Eszter E Bodor Miklos M Borissova Anna Maria AM Boyanov Mihail M Buffet Camille C Burlacu Maria-Cristina MC Ćirić Jasmina J Díez Juan J JJ Dobnig Harald H Fadeyev Valentin V Field Benjamin C T BCT Fliers Eric E Frølich Jacob Stampe JS Führer Dagmar D Galofré Juan Carlos JC Hakala Tommi T Jiskra Jan J Kopp Peter P Krebs Michael M Kršek Michal M Kužma Martin M Lantz Mikael M Lazúrová Ivica I Leenhardt Laurence L Luchytskiy Vitaliy V McGowan Anne A Melo Miguel M Metso Saara S Moran Carla C Morgunova Tatyana T Mykola Tronko T Beleslin Biljana Nedeljković BN Niculescu Dan Alexandru DA Perić Božidar B Planck Tereza T Poiana Catalina C Puga Francisca Marques FM Robenshtok Eyal E Rosselet Patrick P Ruchala Marek M Riis Kamilla Ryom KR Shepelkevich Alla A Unuane David D Vardarli Irfan I Visser W Edward WE Vrionidou Andromachi A Younes Younes R YR Yurenya Elena E Hegedüs Laszlo L

Frontiers in endocrinology 20231107

<h4>Introduction</h4>Thyroid 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.<h4>Methods</h4>Thyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS). Geographic regions we ...[more]

PMID: 38027187

Similar Datasets

Project description:ObjectiveManagement of hypothyroidism is controversial because of medication cost pressures and scientific uncertainty on how to address treatment dissatisfaction experienced by some patients. The objective was to investigate the experience and preferences of UK endocrinologists in use of thyroid hormones.DesignWeb-based survey.PatientsUK endocrinologists were invited to participate.MeasurementsResponses to questionnaire.ResultsThe response rate was 21% (272/1295). While levothyroxine monotherapy is regarded as the treatment of choice for hypothyroidism, 51% of respondents stated that combined treatment with levothyroxine and liothyronine could be considered for levothyroxine-treated patients whose symptoms persist despite normalisation of serum thyroid stimulating hormone (TSH) concentration. However, only 40% are currently prescribing such treatment, and just 23% would consider taking it themselves. A small minority prescribe desiccated thyroid extract, and those most likely to do so are aged over 60 years. Most respondents stated that they have no influence over brand or formulation of levothyroxine dispensed to their patients and expect no major differences in efficacy between different formulations. A total of 9% would prescribe levothyroxine for euthyroid enlarging goitre, and 29% for euthyroid female infertility with high titre thyroid peroxidase antibodies, despite recent trials finding no benefit.ConclusionsUK endocrine practice in management of hypothyroidism is broadly in line with international guidance. However, a minority of respondents would consider thyroid hormone supplementation in euthyroid individuals for female infertility, enlarging goitre, and other indications in which evidence of efficacy is lacking. Willingness to consider prescribing combined levothyroxine and liothyronine, for hypothyroid symptoms which persist despite normalised TSH, has increased in comparison to previous international surveys, despite inconsistent evidence of benefit.

Project description:BackgroundApproximately 15% more patients taking levothyroxine (LT4) report impaired quality of life compared to controls. This could be explained by additional diagnoses independently affecting quality of life and complicating assignment of causation. This study sought to investigate the underpinnings of reduced quality of life in hypothyroid patients and to provide data for discussion at a symposium addressing hypothyroidism.MethodsAn online survey for hypothyroid patients was posted on the American Thyroid Association Web site and forwarded to multiple groups. Respondents were asked to rank satisfaction with their treatment for hypothyroidism and their treating physician. They also ranked their perception regarding physician knowledge about hypothyroidism treatments, need for new treatments, and life impact of hypothyroidism on a scale of 1-10. Respondents reported the therapy they were taking, categorized as LT4, LT4 and liothyronine (LT4 + LT3), or desiccated thyroid extract (DTE). They also reported sex, age, cause of hypothyroidism, duration of treatment, additional diagnoses, and prevalence of symptoms.ResultsA total of 12,146 individuals completed the survey. The overall degree of satisfaction was 5 (interquartile range [IQR] = 3-8). Among respondents without self-reported depression, stressors, or medical conditions (n = 3670), individuals taking DTE reported a higher median treatment satisfaction of 7 (IQR = 5-9) compared to other treatments. At the same time, the LT4 treatment group exhibited the lowest satisfaction of 5 (IQR = 3-7), and for the LT4 + LT3 treatment group, satisfaction was 6 (IQR = 3-8). Respondents taking DTE were also less likely to report problems with weight management, fatigue/energy levels, mood, and memory compared to those taking LT4 or LT4 + LT3.ConclusionsA subset of patients with hypothyroidism are not satisfied with their current therapy or their physicians. Higher satisfaction with both treatment and physicians is reported by those patients on DTE. While the study design does not provide a mechanistic explanation for this observation, future studies should investigate whether preference for DTE is related to triiodothyronine levels or other unidentified causes.

Dataset Information

Characteristics of specialists treating hypothyroid patients: the "THESIS" collaborative.

Introduction

Methods

Results

Discussion

Publications

Characteristics of specialists treating hypothyroid patients: the "THESIS" collaborative.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets