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This is a debate post. The authors are responsible for the opinions.
In Jämtland, 5,800 people are taking medication for thyroid disease, but it is not certain whether they are receiving the right care. Half of those affected have never been called to see a doctor to follow up on their treatment, according to a new member survey by the Thyroid Association. The lack of national coordination puts patient safety at risk.
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An underactive thyroid, hypothyroidism, is one of the most common chronic diseases in the country and usually requires lifelong treatment with levothyroxine (Levaxin/Euthyrox). Common symptoms include fatigue, depression, memory problems, pain and infertility.
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Half of our survey participants, 49 percent, have never been invited to a doctor’s visit to follow up on their treatment, even though a medical examination should take place every year or two. This is shown in the Thyroid Association’s new report “Follow-up of hypothyroidism in Primary Care”, which is based on a member survey with 2,700 respondents.
The survey also shows that over half, 54 percent, have been asked to change their dose by letter, message or chat based on their test results alone, without the doctor asking how they are doing on their current dose.
One in four, 24 percent, say that in their opinion the treatment is not working well and that many symptoms of hypothyroidism still exist. Only 16 percent say they are feeling well and no longer have any symptoms.
The consequences of a lack of aftercare are diverse. Both under- and over-treatment with levothyroxine result in decreased quality of life, side effects, and complications. There is also a risk of incorrect treatment. For the Jämtland Härjedalen region, this is likely to result in higher healthcare costs and for the state in higher sick leave costs.
Our appeal to the Jämtland Härjedalen region is that the region urgently review its hypothyroidism treatment follow-up routines so that all patients receive the recommended follow-up with regular sampling and clinical assessment.
In addition, Sweden’s municipalities and regions need to develop a national hypothyroidism care program with criteria for diagnosis, treatment and follow-up.
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Overall, this would save resources and create efficiencies, as well as improve the lives of the thousands of people in Jämtland who suffer from thyroid disease.
Robert Ingvarsson, Chairman of the Thyroid Association in Jämtland County
Katarina Nydahl, doctor of pharmacy and medical expert at the Thyroid Association
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Hypothyroidism Facts:
1. The thyroid produces vital hormones that, among other things, control the body’s metabolism.
2. A lack of thyroid hormones leads to a low metabolism.
3. Common symptoms include fatigue, depression, memory problems, pain and infertility.
The report in five points:
The survey among members of the thyroid association shows:
1. Half have never been called to see a doctor to follow up on their treatment, even though if the treatment is well controlled, a medical check-up should take place every year or two.
2. 3 in 10 are called for sampling less than once every three years, although annual checks are recommended. Only half are called once a year.
3. A third often receive a new prescription without a sample being taken to show the patient’s current thyroid levels. Nearly half often receive their prescription renewals without a physical visit, a digital visit, a phone contact or a chat.
4. Over half were instructed to change their dose via letter or message/chat based solely on their test results, without the doctor asking how they were doing on their current dose. That is, without clinical assessment and without dialogue in which the patient could be involved in decisions about his treatment.
5. One in four say they think treatment is working poorly and that they have many residual symptoms of hypothyroidism.
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