DR.Guttler’s Patient Thyroid Blog Post #12 Patient satisfaction and quality of life in hypothyroidism:

Dr.Guttler’s Comments:

1. In this study 969 hypothyroid patients answered the QoL questions.
2. Dissatisfaction with treatment was common (77.6%), and overall QOL scores were low.
3. There was no significant between LT4 vs LT4/LT3 combination treatment. or thyroid extract.
4. Multiple parameters including prior healthcare experiences and expectations influence satisfaction with hypothyroidism treatment and QOL. Focusing on enhancing the patient experience and clarifying expectations at diagnosis may improve satisfaction and QOL.
5. If you have Hashimoto’s thyroiditis hypothyroidism will happen to you.
6. However, if you have surgery, even lobectomy for benign thyroid nodules or small thyroid cancers, there is a high chance you will need thyroid hormone therapy for life.
7. This will add decreased quality of life issues from surgery, to life long QoL issues from hypothyroidism.
8. Think twice before have surgery for benign nodular disease or small <1.5 cm low risk papillary thyroid cancers.
9. Get outside opinions before thinking about surgery.
10. Call me for evaluation before you have the surgery.
11. 3190393-8860 or email to thyroid.manager@thyroid.com
12. Ask for Alicia
13. DrG

Clinical EndocrinologyVolume 94, Issue 3 p. 513-520 Anna L. Mitchell et al

Objective

Dissatisfaction with treatment and impaired quality of life (QOL) are reported among people with treated hypothyroidism. We aimed to gain insight into this.

Design and patients

We conducted an online survey of individuals with self-reported hypothyroidism.

Results

Nine hundred sixty-nine responses were analysed. Dissatisfaction with treatment was common (77.6%), and overall QOL scores were low. Patient satisfaction did not correlate with type of thyroid hormone treatment, but treatment with combination levothyroxine (L-T4) and liothyronine (L-T3) or with desiccated thyroid extract (DTE) was associated with significantly better reported QOL than L-T4 or L-T3 monotherapies (P < .001); however, multivariate analysis inclusive of other clinical parameters failed to confirm an association between type of thyroid hormone treatment and QOL or satisfaction. Multivariate analysis showed positive correlations between satisfaction and age (P = .026), male gender (P = .011), being under the care of a thyroid specialist (P < .001), family doctor (GP) prescribing DTE or L-T4 + L-T3 or L-T3 (P < .001) and being well informed about hypothyroidism (P < .001); negative correlations were observed between satisfaction and negative experiences with L-T4 (P < .001) and expectations for more support from the GP (P < .001), for L-T4 to resolve all symptoms (P = .004), and to be referred to a thyroid specialist (P < .001). For QOL, positive correlations were with male gender (P = .011) and duration of hypothyroidism (P = .002); negative correlations were with age (P = .027), visiting the GP more than 3 times before diagnosis (P < .001), sourcing DTE or L-T3 independently (P = .014), negative experiences with L-T4 (P = .013), having expectations for L-T4 to resolve all symptoms (P < .001) and of more support from the GP (P = .006).

Conclusions

Multiple parameters including prior healthcare experiences and expectations influence satisfaction with hypothyroidism treatment and QOL. Focusing on enhancing the patient experience and clarifying expectations at diagnosis may improve satisfaction and QOL.