Racial Disparities in Thyroid Disease Care

Gavigan, Colleen; Cooper, David S.

doi:10.1089/ct.2020;32.529-533

Cited by 2 publications

(1 citation statement)

References 20 publications

(19 reference statements)

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“…While untreated hypothyroidism has become increasingly less common, there is evidence that untreated hypothyroidism remains more likely for certain patient groups, in particular for men, individuals younger than 45 years of age, and those without access to regular health care ( 93 , 94 ). Several studies have examined racial/ethnic factors that influence whether a patient will receive treatment for hypothyroidism ( 95 – 99 ). An analysis of the Cardiovascular Health Study dataset of those aged 65 years and older demonstrated that White women over any other race and sex group were more likely to start treatment with thyroid hormone ( 96 ).…”

Section: Sociodemographic Disparities In Clinical Outcomesmentioning

confidence: 99%

Evaluating health outcomes in the treatment of hypothyroidism

Ettleson

Papaleontiou

2022

Front. Endocrinol.

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Clinical hypothyroidism is defined by the inadequate production of thyroid hormone from the thyroid gland to maintain normal organ system functions. For nearly all patients with clinical hypothyroidism, lifelong treatment with thyroid hormone replacement is required. The primary goal of treatment is to provide the appropriate daily dose of thyroid hormone to restore normal thyroid function for each individual patient. In current clinical practice, normalization of thyrotropin (TSH) level is the primary measure of effectiveness of treatment, however the use of a single biomarker to define adequate thyroid hormone replacement is being reevaluated. The assessment of clinical health outcomes and patient-reported outcomes (PROs), often within the context of intensity of treatment as defined by thyroid function tests (i.e., undertreatment, appropriate treatment, or overtreatment), may play a role in evaluating the effectiveness of treatment. The purpose of this narrative review is to summarize the prominent health outcomes literature in patients with treated hypothyroidism. To date, overall mortality, cardiovascular morbidity and mortality, bone health and cognitive function have been evaluated as endpoints in clinical outcomes studies in patients with treated hypothyroidism. More recent investigations have sought to establish the relationships between these end results and thyroid function during the treatment course. In addition to clinical event outcomes, patient-reported quality of life (QoL) has also been considered in the assessment of adequacy of hypothyroidism treatment. From a health care quality perspective, treatment of hypothyroidism should be evaluated not just on its effectiveness for the individual patients but also to the extent to which patients of different sociodemographic groups are treated equally. Ultimately, more research is needed to explore differences in health outcomes between different sociodemographic groups with hypothyroidism. Future prospective studies of treated hypothyroidism that integrate biochemical testing, PROs, and end result clinical outcomes could provide a more complete picture into the effectiveness of treatment of hypothyroidism.

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