Endocrine Abstracts

JOINT2110

Introduction: Hypothyroidism is a common clinical problem requiring life-long treatment and follow-up. Even though the management of hypothyroidism is generally straightforward, several studies shown that a large percentage of patients are over or under-treated and the drug adherence is also sub-optimal. The aim of this study was to evaluate drug adherence and factors associated with non-adherence, determine the attainement of the euthyroidism and evaluate the depressive status.

Method: 300 patients treated for hypothyroidism at least for one year were included. Patients were administered eight-item Modified Morisky Medication Adherence Scale (MMAS-8), a structured self-reporting medication adherence measure to identify the behaviour of patients with regard to prescribed medications. They were evaluated for the medication use habits, comorbidities and drugs used together with levothyroxine, nutritional habits. Beck depression scale was applied to all patients.

Results: According to MMAS-8 scale, 29.67% of the patients have low drug adherence, 36.67% have moderate adherence and 33.67% of the patients have good drug adherence. Male and female patients have similar MMAS-8 scores. The mean age of the low adherent group was lower significantly ( P = 0.009). TSH levels of the patients with good adherence was lower than moderate and low adherence groups significantly (P >0.001). 99.33% of the patients were taking levothyroxine at morning before breakfast. 17.33% of the patients were having breakfast within 30 minutes after taking the levothyroxine, 38.67% were having breakfast within 30-60 minutes. 12.67% of the patients were taking together with another medication. The MMAS-8 score was not associated with etiology of hypothyroidism and education background. 32.67% of the patients have moderate or severe deppression. There was no relation between MMAS-8 score and Beck depression score when evaluated by cathegorisation but the depression scores of the good adherent patients was lower significantly ( P = 0.002). Mean TSH level of patients with severe depression was higher significantly ( P = 0.007). Beck depression scores of the female group was significantly higher ( P = 0.001). Beck depression scores of the patients with TSH<0.5 and TSH>4 were higher than the group with TSH between 0.5-4 Mıu/l.

Conclusion: 29.67% of the patients in study group had poor drug adherence. Drug adherence scores were not associated with hypothyroidism etiology, disease duration, levothyroxine dose or education background. Younger patients had lower drug adherence. TSH levels of the patients with severe depression was significantly higher. Follow-up of the patients and regular doctor visits is important for detection of drug adherence and keeping patients euthyroid.