Evaluation of the correct use of levothyroxine in patients with hypothyroidism
İntroduction: Standard treatment for hypothyroidism is replacement with synthetic Levothyroxine (LT4) sodium preparations. LT4 should be taken on an empty stomach at least 30 minutes before a meal, as maximal absorption occurs when taken on an empty stomach. Protein Pump Inhibitor (PPI), iron sulphate, calcium carbonate have been shown to reduce the absorption of LT4 when taken together with LT4. Therefore, patients receiving LT4 should be informed to take their drugs at least 4 hours before drugs that interact with thyroid hormone absorption.
Objective: The aim of this study is to evaluate the correct use of levothyroxine drug, which is widely used in the society, in patients with hypothyroidism, to reveal the reasons for misuse, and to associate the number of drugs used by patients, types and chronic diseases.
Material and method: Our study was conducted with a face-to-face questionnaire consisting of 18 questions in patients who applied to Recep Tayyip Erdoğan University Education and Research Hospital Endocrinology and Metabolic Diseases Polyclinic and Family Medicine outpatient clinic between 10-20 June 2020 and used LT4 due to any reason of hypothyroidism, and by obtaining patient consent.
Results: 103 patients, 15 men and 88 women, participated in our study. 103 (100%) of the patients participating in our study took their medication in the morning and stored it in the right place. 94 of them (91.3%) took their medication regularly. 92 of them (89.3%) used their medicine at least 30 minutes before the meal. 60 of the patients (58.25%) used their medication correctly. 18 (41.9%) of the 43 people who used wrong medication were using PPI, 7 (16.3%) calcium carbonate, 5 (11.6%) ferrous sulfate. When compared in terms of correct use, a statistically significant difference (p <0.05) was found in patients with gender, age, presence of hypertension, presence of chronic disease, number of drugs used, ppi use, and calcium carbonate use.
Conclusion: Our study highlights the insufficient knowledge about LT4 therapy among hypothyroid patients, the high prevalence of faulty applications, and the reasons for misapplication. These factors can lead to non-compliance and patient care not being optimal. It is important for physicians to inform patients about how to use the drug in terms of follow-up and treatment of the disease.
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