ArticleBMJ open2018
Attitudes and perceptions of health professionals towards management of hypothyroidism in general practice: a qualitative interview study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Thyroid hormone therapy in a population cohort over two decades indicates persistent overtreatment.European thyroid journal · 2026Article
- Physician-reported barriers and facilitators to thyroid hormone deprescribing in older adults.Journal of the American Geriatrics Society · 2025Article
- Treating subclinical hypothyroidism in individuals with or without mental health problems -A Delphi based expert consensus study in two countries.Frontiers in endocrinology · 2023Article
- Use of thyroid hormones in hypothyroid and euthyroid patients: a THESIS* survey of Belgian specialists *THESIS: treatment of hypothyroidism in Europe by specialists: an international survey.Thyroid research · 2022Article
- Factors influencing patients' opt-in intention of exchanging health information.Frontiers in public health · 2022Article
- Liothyronine for hypothyroidism: a candidate for disinvestment or in need of further research? A value of information analysis.BMJ open · 2021Article
- T4+T3 Combination Therapy: An Unsolved Problem of Increasing Magnitude and Complexity.Endocrinology and metabolism (Seoul, Korea) · 2021Article
- Correlation between TSH levels and quality of life among subjects with well-controlled primary hypothyroidism.Endocrine · 2021Article
- Improving the Quality of Life of Patients with an Underactive Thyroid Through mHealth: A Patient-Centered Approach.Women's health reports (New Rochelle, N.Y.) · 2021Article
- Patient Requests for Tests and Treatments Impact Physician Management of Hypothyroidism.Thyroid : official journal of the American Thyroid Association · 2019Article
- T4 + T3 combination therapy: any progress?Endocrine · 2019Review
- Inequitable Long-Term Outcomes for an Indigenous Population After Definitive Treatment of Patients With Graves Disease.Journal of the Endocrine Society · 2019Article
- Combination Thyroid Hormone Replacement; Knowns and Unknowns.Frontiers in endocrinology · 2019Review
- Levothyroxine Administration Techniques Audit and Utility of its Assessment at Each Visit: A Hospital-based Mixed Model Study.Indian journal of endocrinology and metabolismArticle
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Authors and funding
11 authors.
Funding
Abstract
objectiveTo explore the attitudes and perceptions of health professionals towards management of hypothyroidism that contributes to the suboptimal treatment of hypothyroidism in general practice.
designA qualitative interview study using semistructured interviews.
participantsSixteen participants were interviewed between March and August 2016 comprising nine general practitioners (GPs), four pharmacists, two practice nurses and one nurse practitioner.
settingGeneral practice and community pharmacies in the counties of Northumberland, Tyne and Wear, Stockton-on-Tees and North Cumbria, North of England, UK.
methodA grounded-theory approach was used to generate themes from interviews, which were underpinned by the theory of planned behaviour to give explanation to the data.
resultsAlthough health professionals felt that hypothyroidism was easy to manage, GPs and nurses generally revealed inadequate knowledge of medication interactions and levothyroxine pharmacokinetics. Pharmacists felt limited in the advice that they provide to patients due to lack of access to patient records. Most GPs and nurses followed local guidelines, and relied on blood tests over clinical symptoms to adjust levothyroxine dose. The information exchanged between professional and patient was usually restricted by time and often centred on symptoms rather than patient education. Health professionals felt that incorrect levothyroxine adherence was the main reason behind suboptimal treatment, although other factors such as comorbidity and concomitant medication were mentioned. Enablers perceived by health professionals to improve the management of hypothyroidism included continuity of care, blood test reminders, system alerts for interfering medications and prescription renewal, and accessible blood tests and levothyroxine prescriptions for patients.
conclusionThere is a significant health professional behavioural component to the management of hypothyroidism. Addressing the differences in patient and professional knowledge and perceptions could reduce the barriers to optimal treatment, while continuity of care and increased involvement of pharmacists and practice nurses would help to promote optimal thyroid replacement.
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