Assessment of medication adherence and risk factors for hypothyroidism in South Indian Tertiary care hospital: a cross–sectional study

Abstract

The objective of the study was to assess the risk factors for hypothyroidism and the magnitude of medication adherence and the effects of various co-administered drugs on hypothyroidism treatment in a south Indian tertiary care hospital. A cross-sectional study was conducted in 208 subjects (with or without hypothyroidism) from November 2016 to April 2017 in a general medicine department. Odds ratios were calculated in univariate regression analysis for risk factors and magnitude of medication adherence was assessed using MMAS-8 and BMQ questionnaires and the incidence of various prescription drugs interfering with levothyroxine therapy was assessed. Hypothyroidism was significantly higher in the females (84.6%, P<0.0001) with graduation and above level of education (30.8%, P=0.004), significant family history (90.2%, P<0.0001), habit of taking fruit juices (monthly once) (4.9%, P=0.056), habit of taking soft drinks (weekly once) (11.7%, P=0.002), never work with same efficiency (24%, P=0.009), never with normal sleep pattern (20.4%, P=0.046), never take advantage of their free time (13.5%, P=0.049), never likes to be in relationship with others (14.4%, P=0.001) and who never used cardiovascular drugs (87.5%, P<0.0001) than non-hypothyroid subjects. The overall medication adherence level in subjects was found to be 34.6% according to Morisky-8-item questionnaire and 40.4% according to BMQ. Levothyroxine (100%) was the most widely prescribed drug followed by calcium + vitamin D3 (52.8%), glimepiride + metformin (17.28%), multivitamin + multimineral (11.52%) and iron + folic acid (9.6%). Among 60 drug-drug interactions identified, 23 (38.3%) were major, 35 (58.3%) were moderate and 2 (3.33%) were minor-drug interactions. The present study suggested that female gender, level of education upto graduation and above, significant family history, habit of taking fruit juices (monthly once), habit of taking soft drinks (weekly once), never work with same efficiency, never with normal sleep pattern, never take advantage of their free time, never likes to be in relationship with others and who never used cardiovascular drugs are at risk for hypothyroidism. Magnitude of medication adherence according to MMAS-8 and BMQ questionnaires was slightly low.