Frequency of Thyroid-Stimulating Hormone Monitoring in Patients After Thyroidectomy: A Retrospective Study in Primary Care Practices in Germany

Abstract

Aim The goal of this study was to analyze the frequency of thyroid-stimulating hormone (TSH) monitoring in thyroidectomy patients followed by general practitioners in Germany.

Methods This study included all individuals ≥18 years who had undergone a thyroidectomy between 2000 and 2015 in 258 general practices in Germany. Another inclusion criterion was a minimum of three medical visits between 2015 and 2016, following thyroidectomy. The primary outcome was the annual frequency of TSH monitoring in thyroidectomy patients in 2015. Demographic data included age, sex, and type of health insurance coverage (private versus statutory). Clinical and therapeutic data included the amount of time since the first thyroidectomy, thyroidectomy-associated diagnosis (thyroid cancer, noncancerous enlargement of the thyroid (goiter), or hyperthyroidism), type of thyroidectomy (total or hemithyroidectomy), the Charlson Comorbidity Index score, and the prescription of levothyroxine therapy in 2015. A multivariable logistic regression model was performed to identify variables potentially associated with the likelihood of having been tested at least once for TSH in the year 2015.

Results The present study included 1,135 thyroidectomy patients. The mean age was 60.1 years (SD=14.3 years), and 75.8% of the patients were women. TSH was measured at least once in 42.3% of patients. In addition, 31.5% of individuals after thyroidectomy had mean TSH values between 0.25 and 1 mIU/L in 2015. No variable was significantly associated with the frequency of TSH monitoring. However, there was a tendency toward a lower TSH monitoring frequency in the groups which had undergone thyroidectomy years ago (OR=0.77 (95% CI: 0.53–1.11) for 1–5 years and OR=0.67 (95% CI: 0.45–0.99) for>5 years compared to<=1 year).

Conclusions Only 40% of thyroidectomy patients followed by general practitioners in Germany were monitored at least once for TSH in 2015.

Key words

thyroid-stimulating hormone - monitoring - thyroidectomy - primary care

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