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Long-Term Adherence to Levothyroxine Replacement Therapy in Thyroidectomized Patients.

Raffaella Bocale1, Giovambattista Desideri2, Angelina Barini3

  • 1Division of Endocrine Surgery, "Agostino Gemelli" School of Medicine, University Foundation Polyclinic, Catholic University of the Sacred Heart, 00198 Rome, Italy.

Journal of Clinical Medicine
|July 27, 2022
PubMed
Summary

Liquid levothyroxine (L-T4) shows better long-term adherence than solid forms, simplifying treatment for thyroidectomized patients. This study highlights formulation benefits for medication adherence.

Keywords:
adherencelevothyroxinethyroid replacement therapythyroidectomy

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Patient Adherence Studies

Background:

  • Levothyroxine (L-T4) replacement therapy is crucial for thyroidectomized patients.
  • Different L-T4 formulations (liquid vs. solid) may impact adherence due to food interactions.
  • Evaluating long-term adherence differences between liquid and solid L-T4 is important for optimizing patient care.

Purpose of the Study:

  • To compare the long-term adherence of liquid versus solid levothyroxine (L-T4) formulations.
  • To assess the influence of formulation type on patient adherence in thyroidectomized individuals.
  • To investigate the relationship between L-T4 adherence and thyroid hormone levels.

Main Methods:

  • 106 thyroidectomized patients on L-T4 replacement therapy were enrolled.
  • Patients received either liquid (n=52) or solid (n=54) L-T4 formulations.
  • The four-item Medication Adherence Questionnaire (MAQ) was administered to assess adherence.

Main Results:

  • Overall adherence was 59.4%, with 40.6% non-adherence.
  • Liquid L-T4 demonstrated significantly better adherence scores compared to solid L-T4 (p=0.0085).
  • Patients on solid L-T4 reported more frequent missed doses and carelessness; however, many preferred tablets.

Conclusions:

  • Long-term adherence to levothyroxine (L-T4) treatment is generally satisfactory.
  • The liquid formulation of L-T4 appears to offer superior adherence and easier management for thyroidectomized patients.
  • Liquid L-T4 may be particularly beneficial for patients experiencing difficulties with taking medication while fasting.