The Evaluation Of The Common Mistakes In The Use Of Levothyroxine

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 414-431-HPT Axis Biology
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-427
Kerim Kucukler*1, Yasemin Tutuncu1, Gulhan Akbaba1, Serhat Isik1, Ufuk Özuguz1, Ayse Arduc1, Dilek Berker1 and Serdar Guler2
1Ankara Numune Training and Research Hospital, Ankara, Turkey, 2Hitit University Faculty of Medicine, Corum, Turkey
OBJECTIVE: Hypothyroidism, which can be described as insufficiency or rarely ineffectiveness of the hormone on the tissue, is a common condition in the population. The treatment is lifetime in patients with permanent disease and Levothyroxine is used in the treatment. When the thyroid function test results which are not within the normal range are assessed, the mistakes related to the medication use of the patients under treatment are usually ignored. In our study, it is aimed to emphasize these mistakes. 

METHOD:  773 Patients diagnosed with hypothyroidism between July 2011-August 2912 and who were  on Levothyroxine therapy since 6 months ago, were included in the study. Newly diagnosed patients,  patients under the suppressive therapy due to thyroid cancer and patients with central hypothyroidism were excluded from the study. The patients were questioned about their medication use. Not taking medication in daily order, skipping day were considered as irregular use.  Taking medication on a full stomach, Keeping the medication in  the refrigerator, taking the medication at night on a full stomach or both taking the medication on a full stomach and keeping the medication in  the refrigerator were considered as “erroneous use”. TSH levels of all patients were assessed. The range between 0,27-4,7 μIU/mL was considered as normal for TSH values.  

FINDINGS:  90% of 773 patients were females and 10% were males. While 81% of the patients were using the medication as required, 19% of the patients were not using the medication as recommended by their physician. While 89.2% of the patients who were using their medication as required and regularly, had  TSH values within the normal range, THS levels were suppressed in 6,7% of the patients and TSH levels were high in 4.1% of the patients.    

22% of the the patients who were not taking the medication as required had a TSH level within the normal range, TSH values were suppressed in 0,9% of the patients and TSH values were high in  69,3% of the patients. Among the patient who were not taking  the medication as required, irregular use was detected in 51,57% of the patients and erroneous use was detected in 49,43%. 85% of the patients who were taking the medication irregularly had high values of TSH.   

Most common mistakes in the use of Levothyroxine were as follows: Taking the medication on a full stomach 52,7%, keeping the medication in refrigerator 30,43%, taking the medication at the same moment with the other medications 13,4%, taking the medication both on a full stomach and also keeping the medication in  refrigerator. Taking the medication on a full stomach at night 2,17%.

CONCLUSION: The mistakes in the use of Levothyroxine impede achieving the targeted TSH value. Therefore, when prescribing Levothyroxine, the physicians shall inform the patients about the proper use of the medication and emphasize its importance.

Nothing to Disclose: KK, YT, GA, SI, U, AA, DB, SG

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm