Unsafe care for thyroid patients in Jämtland – Östersunds-Posten

In Jämtland, 5,800 people receive medication for thyroid disease, but it is not certain that they are receiving proper care. Half of those affected have never been called in to see a doctor for follow-up treatment, according to a new member survey by the Thyroid Association. The lack of national coordination threatens patient safety.

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Hypothyroidism, one of the most common chronic diseases in the country, usually requires lifelong treatment with levothyroxine (Levaxin/Eutyrox). Common symptoms are fatigue, depression, memory problems, pain, and infertility.

Half of those who responded to our survey, 49 percent, have never been called to see a doctor to follow up on their treatment, even though they should have a check-up every or every two years. This is demonstrated by the Thyroid Society's new report, “Hypothyroidism Monitoring in Primary Care,” which is based on a member survey of 2,700 participants.

The survey also shows that more than half, 54%, have been asked to change their dose via text, message or chat based solely on test results, without the doctor asking how they are doing with their current dose.

One in four, 24 percent, said they thought the treatment was working poorly and that they had many residual symptoms of hypothyroidism. Only 16 percent said they felt well and had no symptoms.

The consequences of not following through are many. Both undertreatment and overtreatment with levothyroxine result in decreased quality of life, side effects, and complications. There is also a risk of incorrect treatment. For the Jämtland Härjedalen region, this is likely to increase healthcare costs and for the state to increase sick leave costs.

Our call to the Jämtland-Harjedalen region is for the region to urgently review its routine procedures for monitoring treatment of hypothyroidism, so that all patients receive follow-up with regular sampling and the recommended clinical assessment.

In addition, municipalities and regions in Sweden need to develop a national care program for hypothyroidism, with standards for diagnosis, treatment and follow-up.

Overall, this would save resources and create efficiencies, as well as improve the lives of thousands of people in Jämtland who suffer from thyroid disease.

Robert Ingvarsson, President of the Thyroid Association of Jämtland County

Katarina Nydal, PharmD and medical expert at the Thyroid Association

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Facts about hypothyroidism:

1. The thyroid gland produces vital hormones that control, among other things, the body's metabolism.

2. Thyroid hormone deficiency leads to decreased metabolism.

3. Common symptoms are fatigue, depression, memory problems, pain and infertility.

The report has five points:

Polling among Thyroid Association members shows:

1. Half of them have never been called to visit a doctor to follow up on their treatment, although a doctor's examination is necessary every or every two years with well-monitored treatment.

2. 3 out of 10 are called for biopsies less frequently than every three years, although annual checkups are recommended. Only half of them are called once a year.

3. One-third often get a renewed prescription without a biopsy showing the patient's current thyroid values. Prescriptions are often renewed for nearly half without a physical visit, digital visit, phone call or chat.

4. More than half were asked to change their dose via text or message/chat based solely on test results, without the doctor asking them how they were doing with their current dose. That is, without clinical evaluation and dialogue, the patient is allowed to participate in decisions related to his treatment.

5. 1 in 4 said they thought the treatment was working poorly and that they had many residual symptoms of hypothyroidism.