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

被引：6

作者：

Attanasio, Roberto ^{[1
,58
]}

Zarkovic, Milos ^{[2
]}

Papini, Enrico ^{[3
]}

Nagy, Endre Vezekenyi ^{[4
]}

Negro, Roberto ^{[5
]}

Perros, Petros ^{[6
]}

Akarsu, Ersin ^{[7
]}

Alevizaki, Maria ^{[8
,9
]}

Ayvaz, Goksun ^{[10
]}

Bednarczuk, Tomasz ^{[11
]}

Beleslin, Biljana Nedeljkovic ^{[2
]}

Berta, Eszter ^{[4
]}

Bodor, Miklos ^{[4
]}

Borissova, Anna Maria ^{[12
]}

Boyanov, Mihail ^{[13
,14
]}

Buffet, Camille ^{[15
]}

Burlacu, Maria-Cristina ^{[16
]}

Ciric, Jasmina ^{[2
]}

Diez, Juan J. ^{[17
,18
,19
]}

Dobnig, Harald ^{[20
,21
]}

Fadeyev, Valentin ^{[22
]}

Field, Benjamin C. T. ^{[23
]}

Fliers, Eric ^{[24
]}

Fuehrer-Sakel, Dagmar ^{[25
]}

Galofre, Juan Carlos ^{[26
,27
]}

Hakala, Tommi ^{[28
]}

Jiskra, Jan ^{[29
]}

Kopp, Peter A. ^{[30
]}

Krebs, Michael ^{[31
]}

Krsek, Michal ^{[29
]}

Kuzma, Martin ^{[32
,33
]}

Lantz, Mikael ^{[34
]}

Lazurova, Ivica ^{[35
]}

Leenhardt, Laurence ^{[15
]}

Luchytskiy, Vitaliy ^{[36
]}

Marques Puga, Francisca ^{[37
]}

McGowan, Anne ^{[38
]}

Metso, Saara ^{[39
]}

Moran, Carla ^{[40
,41
]}

Morgunova, Tatyana ^{[22
]}

Niculescu, Dan Alexandru ^{[42
]}

Peric, Bozidar ^{[43
]}

Planck, Tereza ^{[34
]}

Poiana, Catalina ^{[42
]}

Robenshtok, Eyal ^{[44
,45
]}

Rosselet, Patrick Olivier ^{[46
]}

Ruchala, Marek ^{[47
]}

Riis, Kamilla Ryom ^{[48
]}

Shepelkevich, Alla ^{[49
]}

Tronko, Mykola D. ^{[50
]}

机构：

[1] Assoc Med Endocrinol, Sci Comm, Milan, Italy

[2] Univ Belgrade, Fac Med, Thyroid Dept, Clin Endocrinol Diab & Dis Metab, Belgrade, Serbia

[3] Regina Apostolorum Hosp, Dept Endocrinol & Metab, Rome, Italy

[4] Univ Debrecen, Fac Med, Dept Med, Div Endocrinol, Debrecen, Hungary

[5] Osped Fazzi, Div Endocrinol, Lecce, Italy

[6] Newcastle Univ, Inst Translat & Clin Res, Newcastle Upon Tyne, Northumberland, England

[7] Gaziantep Univ, Fac Med, Dept Internal Med, Div Endocrinol, Gaziantep, Turkiye

[8] Natl & Kapodistrian Univ Athens, Alexandra Hosp, Sch Med, Dept Clin Therapeut,Endocrine Unit, Athens, Greece

[9] Natl & Kapodistrian Univ Athens, Alexandra Hosp, Diabet Ctr, Sch Med,Diab Ctr, Athens, Greece

[10] Koru Ankara Hosp, Dept Endocrinol & Metab, Ankara, Turkiye

[11] Med Univ Warsaw, Dept Internal Med & Endocrinol, Warsaw, Poland

[12] Sofia Univ St Kliment Ohridski, Univ Hosp Sofiamed, Med Fac, Clin Endocrinol & Metab, Sofia, Bulgaria

[13] Univ Hosp Alexandrovska, Clin Endocrinol & Metab, Sofia, Bulgaria

[14] Med Univ Sofia, Dept Internal Med, Sofia, Bulgaria

[15] Sorbonne Univ, Hop Pitie Salpetriere, AP HP,Thyroid Dis & Endocrine Tumor Dept, GRC Thyroid Tumors,GRC 16, Paris, France

[16] Catholic Univ Louvain, Clin Univ St Luc, Dept Endocrinol Diabetol & Nutr, Brussels, Belgium

[17] Hosp Univ Puerta de Hierro Majadahonda, Dept Endocrinol, Madrid, Spain

[18] Inst Invest Sanitaria Puerta Hierro Segovia de Ar, Madrid, Spain

[19] Univ Autonoma Madrid, Dept Med, Madrid, Spain

[20] Thyroid & Osteoporosis Praxis, Kumberg, Austria

[21] Thyroid Practice Radiofrequency Ablat, Vienna, Austria

[22] IM Sechenov First Moscow State Med Univ, NV Sklifosovsky Inst Clin Med, Dept Endocrinol 1, Moscow, Russia

[23] Univ Surrey, Fac Hlth & Med Sci, Sect Clin Med, Guildford, Surrey, England

[24] Univ Amsterdam, Dept Endocrinol & Metab, Amsterdam UMC, Amsterdam, Netherlands

[25] Univ Hosp Essen, Univ Duisburg Essen, Dept Endocrinol Diabet & Metab, Essen, Germany

[26] Clin Univ Navarra, Dept Endocrinol, Pamplona, Spain

[27] Inst Invest Sanitaria Navarra, Pamplona, Spain

[28] Tampere Univ Hosp, Dept Surg, Tampere, Finland

[29] Charles Univ Prague, Gen Univ Hosp, Fac Med 1, Dept Med 3, Prague, Czech Republic

[30] Univ Lausanne, Div Endocrinol Diabet & Metab, Lausanne, Switzerland

[31] Med Univ Vienna, Div Endocrinol & Metab Internal Med 3, Vienna, Austria

[32] Comenius Univ, Dept Internal Med 5, Fac Med, Bratislava, Slovakia

[33] Univ Hosp, Bratislava, Slovakia

[34] Skane Univ Hosp, Dept Endocrinol, Malmo, Sweden

[35] PJ Safarik Univ Kosice, Fac Med, Dept Internal Med 1, Kosice, Slovakia

[36] Natl Acad Med Sci Ukraine, Inst Endocrinol & Metab, Dept Reprod Endocrinol, Kiev, Ukraine

[37] Ctr Hosp Univ Santo Antonio, Endocrinol Diabet & Metab Serv, Porto, Portugal

[38] Tallaght Univ Hosp, Robert Graves Inst, Dublin, Ireland

[39] Tampere Univ Hosp, Dept Endocrinol, Tampere, Finland

[40] Beacon Hosp, Diabet & Endocrinol Sect, Dublin, Ireland

[41] Univ Coll Dublin, Sch Med, Dublin, Ireland

[42] Carol Davila Univ Med & Pharm, Dept Endocrinol, Bucharest, Romania

[43] Univ Hosp Ctr Sisters Mercy, Dept Endocrinol Diabet & Metab Dis Mladen Sekso, Zagreb, Croatia

[44] Tel Aviv Univ, Beilinson Hosp, Endocrinol & Metab Inst, Sackler Fac Med,Thyroid Canc Serv,Rabin Med Ctr, Petah Tiqwa, Israel

[45] Tel Aviv Univ, Sackler Fac Med, Davidoff Canc Ctr, Rabin Med Ctr, Petah Tiqwa, Israel

[46] Cabinet Med 2, Lausanne, Switzerland

[47] Poznan Univ Med Sci, Dept Endocrinol Metab & Internal Med, Poznan, Poland

[48] Odense Univ Hosp, Dept Endocrinol, Odense C, Denmark

[49] Belarusian State Med Univ, Dept Endocrinol, Minsk, BELARUS

[50] Ukraine Acad Med Sci, VP Komisarenko Inst Endocrinol & Metab, Kiev, Ukraine

来源：

THYROID | 2024年 / 34卷 / 04期

关键词：

survey; hypothyroidism; levothyroxine; triiodothyronine; quality of life; geo-economics; ASTERISK QUESTIONNAIRE SURVEY; EUTHYROID PATIENTS; TREATING HYPOTHYROIDISM; COMBINATION THERAPY; HORMONES; GUIDELINES; MANAGEMENT;

D O I：

10.1089/thy.2023.0580

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：429 / 441

页数：13

共 60 条

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