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An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction.
Thyroid. 2018 06; 28(6):707-721.T

Abstract

BACKGROUND

Approximately 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.

METHODS

An 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.

RESULTS

A 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.

CONCLUSIONS

A 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.

Authors+Show Affiliations

1 Division of Endocrinology and Metabolism, Rush University Medical Center , Chicago, Illinois.2 Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania.3 Division of Endocrinology, Mayo Clinic , Rochester, Minnesota.4 Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine , Cardiff, United Kingdom .5 Division of Endocrinology, Diabetes and Nutrition, Boston Medical Center/Boston University , Boston, Massachusetts.6 Division of Endocrinology, Beth Israel Deaconess Medical Center , Boston, Massachusetts.7 Feinberg School of Medicine, Northwestern University , Chicago, Illinois.8 Thyroid Associates, Massachusetts General Hospital , Boston, Massachusetts.9 Oregon Clinical and Translational Research Institute, Oregon Health and Science University , Portland, Oregon.10 University Health Network and University of Toronto , Toronto, Canada .4 Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine , Cardiff, United Kingdom .11 Division of Endocrinology, Georgetown University , Washington, DC.1 Division of Endocrinology and Metabolism, Rush University Medical Center , Chicago, Illinois.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29620972

Citation

Peterson, Sarah J., et al. "An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction." Thyroid : Official Journal of the American Thyroid Association, vol. 28, no. 6, 2018, pp. 707-721.
Peterson SJ, Cappola AR, Castro MR, et al. An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction. Thyroid. 2018;28(6):707-721.
Peterson, S. J., Cappola, A. R., Castro, M. R., Dayan, C. M., Farwell, A. P., Hennessey, J. V., Kopp, P. A., Ross, D. S., Samuels, M. H., Sawka, A. M., Taylor, P. N., Jonklaas, J., & Bianco, A. C. (2018). An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction. Thyroid : Official Journal of the American Thyroid Association, 28(6), 707-721. https://doi.org/10.1089/thy.2017.0681
Peterson SJ, et al. An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction. Thyroid. 2018;28(6):707-721. PubMed PMID: 29620972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An Online Survey of Hypothyroid Patients Demonstrates Prominent Dissatisfaction. AU - Peterson,Sarah J, AU - Cappola,Anne R, AU - Castro,M Regina, AU - Dayan,Colin M, AU - Farwell,Alan P, AU - Hennessey,James V, AU - Kopp,Peter A, AU - Ross,Douglas S, AU - Samuels,Mary H, AU - Sawka,Anna M, AU - Taylor,Peter N, AU - Jonklaas,Jacqueline, AU - Bianco,Antonio C, Y1 - 2018/04/05/ PY - 2018/4/6/pubmed PY - 2019/5/10/medline PY - 2018/4/6/entrez KW - T3 KW - TSH KW - combination therapy KW - desiccated thyroid extract KW - hypothyroidism KW - levothyroxine SP - 707 EP - 721 JF - Thyroid : official journal of the American Thyroid Association JO - Thyroid VL - 28 IS - 6 N2 - BACKGROUND: Approximately 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. METHODS: An 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. RESULTS: A 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. CONCLUSIONS: A 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. SN - 1557-9077 UR - https://www.unboundmedicine.com/medline/citation/29620972/An_Online_Survey_of_Hypothyroid_Patients_Demonstrates_Prominent_Dissatisfaction_ L2 - https://www.liebertpub.com/doi/full/10.1089/thy.2017.0681?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -