| Thyroid hormone replacement in women of reproductive age: is surgeon knowledge related to operative volume? | |
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MedLine Citation:
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PMID: 20469966 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: It is not known if surgeons who place women of reproductive age on thyroid hormone replacement (levothyroxine, LT4) routinely inform them of the increased LT4 demands with future pregnancy. In addition, it is not clear whether reading the 2007 Endocrine Society's "Guidelines on the Management of Thyroid Dysfunction during Pregnancy and Postpartum" influences the role of the surgeon in patient education. The objective of this study was to identify the role of the surgeon in patient education at the time of initiation of LT4 therapy. METHODS: A two-sided one-page survey was distributed to the 260 surgeons attending the 2009 American Association of Endocrine Surgeons' meeting. Of those distributed, 109 (42%) surgeons returned the survey. RESULTS: Although only 26/109 (23%) read the 2007 Endocrine Society's "Guidelines on the Management of Thyroid Dysfunction during Pregnancy and Postpartum," reading the guidelines was associated with a significantly greater likelihood of informing patients of higher LT4 requirements with pregnancy (p < 0.0001). Eighty-five percent of those who read the guidelines "often" or "always" informed patients of higher LT4 requirements with future pregnancy, whereas only 44% of those who did not read the guidelines provided the same level of education. After controlling for surgeon sex, academic versus private practice, years in practice, and number of surgeries performed in 2008, the only independent predictor of patient education was reading the guidelines (p = 0.006). On multivariable analysis, surgeon volume was associated with reading the guidelines (p = 0.006). The mean number of thyroid surgeries performed by those who read the guidelines versus those who did not was 164.46 +/- 16.98 versus 115.01 +/- 8.27 (p = 0.005). CONCLUSION: Surgeons who read the Endocrine Society's "Guidelines on the Management of Thyroid Dysfunction during Pregnancy and Postpartum" were significantly more likely to inform patients of the need for higher LT4 doses with pregnancy. Thyroid surgery volume was associated with guideline awareness. |
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Authors:
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Megan R Haymart; Max A Cayo; Herbert Chen |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Thyroid : official journal of the American Thyroid Association Volume: 20 ISSN: 1557-9077 ISO Abbreviation: Thyroid Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-17 Completed Date: 2010-09-20 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 9104317 Medline TA: Thyroid Country: United States |
Other Details:
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Languages: eng Pagination: 627-31 Citation Subset: IM |
Affiliation:
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Division of Metabolism, Endocrinology, and Diabetes, Department of Medicine, University of Michigan Health System, Ann Arbor, Michigan 48109, USA. meganhay@med.umich.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Endocrine Surgical Procedures
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statistics & numerical data* Female Hormone Replacement Therapy* Humans Hypothyroidism / drug therapy Male Patient Education as Topic* Physicians Practice Guidelines as Topic Pregnancy Pregnancy Complications / drug therapy Thyroid Diseases / drug therapy* Thyroid Gland / physiology, surgery* Thyroid Neoplasms / surgery Thyroxine / therapeutic use* |
| Grant Support | |
ID/Acronym/Agency:
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K12087718//PHS HHS |
| Chemical | |
Reg. No./Substance:
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7488-70-2/Thyroxine |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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