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Tytuł:
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Prevalence and factors associated with chronic use of levothyroxine: A cohort study.
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Autorzy:
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Janett-Pellegri C; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Wildisen L; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Feller M; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Del Giovane C; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Moutzouri E; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Grolimund O; SASIS AG, Solothurn, Switzerland.
Walter P; Santésuisse, Solothurn, Switzerland.
Waeber G; Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Marques-Vidal P; Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Vollenweider P; Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Rodondi N; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
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Źródło:
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PloS one [PLoS One] 2021 Dec 20; Vol. 16 (12), pp. e0261160. Date of Electronic Publication: 2021 Dec 20 (Print Publication: 2021).
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: San Francisco, CA : Public Library of Science
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MeSH Terms:
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Diabetes Mellitus/*drug therapy
Drug Utilization/*statistics & numerical data
Hypertension/*drug therapy
Thyroid Gland/*pathology
Thyroxine/*therapeutic use
Adult ; Aged ; Cohort Studies ; Diabetes Mellitus/pathology ; Female ; Humans ; Hypertension/pathology ; Male ; Middle Aged ; Thyroid Gland/drug effects
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References:
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Substance Nomenclature:
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Q51BO43MG4 (Thyroxine)
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Entry Date(s):
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Date Created: 20211220 Date Completed: 20220113 Latest Revision: 20220113
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Update Code:
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20240104
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PubMed Central ID:
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PMC8687586
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DOI:
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10.1371/journal.pone.0261160
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PMID:
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34928965
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Importance: Levothyroxine prescriptions are rising worldwide. However, there are few data on factors associated with chronic use.
Objective: To assess the prevalence of chronic levothyroxine use, its rank among other chronic drugs and factors associated with chronic use. To assess the proportion of users outside the therapeutic range of thyroid-stimulating hormone (TSH).
Design: Cohort study (CoLaus|PsyCoLaus) with recruitment from 2003 to 2006. Follow-ups occurred 5 and 10 years after baseline.
Participants: A random sample of Lausanne (Switzerland) inhabitants aged 35-75 years.
Main Outcomes: We evaluated the prevalence of chronic levothyroxine use and we then ranked it among the other most used chronic drugs. The ranking was compared to data from health insurance across the country. We assessed the association between each factor and chronic levothyroxine use in multivariable logistic regression models. The proportion of chronic levothyroxine users outside the usual TSH therapeutic range was assessed.
Results: 4,334 participants were included in the analysis (mean±SD age 62.8±10.4 years, 54.9% women). 166 (3.8%) participants were chronic levothyroxine users. Levothyroxine was the second most prescribed chronic drug after aspirin in the cohort (8.2%) and the third most prescribed when using Swiss-wide insurance data. In multivariable analysis, chronic levothyroxine use was associated with increasing age [odds ratio 1.03, 95% confidence interval 1.01-1.05 per 1-year increase]; female sex [11.87 (5.24-26.89)]; BMI [1.06 (1.02-1.09) per 1-kg/m2 increase]; number of concomitant drugs [1.22 (1.16-1.29) per 1-drug increase]; and family history of thyroid pathologies [2.18 (1.37-3.48)]. Among chronic levothyroxine users with thyroid hormones assessment (n = 157), 42 (27%) were outside the TSH therapeutic range (17% overtreated and 10% undertreated).
Conclusions: In this population-based study, levothyroxine ranked second among chronic drugs. Age, female sex, BMI, number of drugs and family history of thyroid pathologies were associated with chronic levothyroxine use. More than one in four chronic users were over- or undertreated.
Competing Interests: Commercial affiliation of OG and PW did not alter their adherence to PLOS ONE policies on sharing data and materials. Other authors have nothing to disclose.
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