Prescribing Therapy for Hypothyroidism: Influence of Physician Characteristics. (Record no. 6114)

000 -LEADER
fixed length control field 04547nam a22005777a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 181108s20192019 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 1050-7256
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 10.1089/thy.2018.0369 [doi]
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
Classification number 30375273
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Jonklaas, Jacqueline
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Shara, Nawar M
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Tefera, Eshetu
190 ## -
-- Jonklaas J
190 ## -
-- Shara N
190 ## -
-- Tefera E
245 ## - TITLE STATEMENT
Title Prescribing Therapy for Hypothyroidism: Influence of Physician Characteristics.
251 ## -
-- Thyroid. 29(1):44-52, 2019 01.
252 ## -
-- Thyroid. 29(1):44-52, 2019 01.
253 ## -
-- Thyroid : official journal of the American Thyroid Association
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Date of publication, distribution, etc. 2019
260 ## - PUBLICATION, DISTRIBUTION, ETC.
-- aheadofprint
260 ## - PUBLICATION, DISTRIBUTION, ETC.
-- ppublish
260 ## - PUBLICATION, DISTRIBUTION, ETC.
-- 2018
269 ## -
-- FY2019
501 ## - WITH NOTE
With note Available online from MWHC library: August 2000 - present, Available in print through MWHC library: 1999 - 2006
520 ## - SUMMARY, ETC.
Summary, etc. Background Physician characteristics and perceptions and their effect on choice of therapies for patients with thyroid cancer have been well-studied. Some data also exist about physician characteristics and prescribing treatment for subclinical hypothyroidism. The effect of physician characteristics on prescribing thyroid preparations for treating overt hypothyroidism is less studied. Methods Members of the American Thyroid Association were surveyed in 2017. Physicians were presented with thirteen different theoretical patients with hypothyroidism and asked to choose among 6 therapeutic options, including levothyroxine, synthetic combination therapy, thyroid extract, and liothyronine monotherapy. The thirteen patient scenarios incorporated parameters that potentially provide reasons for considering combination therapy (presence of symptoms, low serum triiodothyronine concentration, documentation of deiodinase polymorphisms). Repeated measures logistic regression analysis was performed to examine the prescribing of the various therapies. Data regarding the responding physicians were also collected. These data included number of years in practice, country of practice, and specialty. Multivariate repeated measures logistic regression analysis of prescribing patterns was also conducted controlling for all patient and physician characteristics. Results Ninety-three percent of the 389 survey respondents prescribed therapy for hypothyroidism. Fifty-three percent of respondents had been in practice for more than 20 years and 23% had been in practice for 11-20 years. Sixty-four percent practiced in North America and 18% practiced in Europe. Eight-six percent were endocrinologists and 5% were surgeons. In multivariate analysis physicians from North America remained both more likely to prescribe any triiodothyronine-containing therapies (OR 1.8 [1.3-2.4]) and more likely to add liothyronine to levothyroxine therapy (OR 1.9 [1.2-2.9]). In addition, they were also more likely to prescribe desiccated thyroid extract or liothyronine monotherapy (OR 1.7 [1.0-2.9]). Conclusions A previous analysis of this survey showed that patient characteristics profoundly affect physician prescribing patterns. The current multivariate analysis also shows that physician characteristics affect prescribing patterns. Whether this is due to impact upon physicians of patient-related experiences, media exposure, influence from pharmaceutical companies, educational activities, or other concerns cannot be determined. However, these results have potential importance for understanding physician-patient interactions at a time when the benefits and risks of triiodothyronine-containing therapies have not been fully documented.
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Hormone Replacement Therapy
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Hypothyroidism/dt [Drug Therapy]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Practice Patterns, Physicians'
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Thyroxine/tu [Therapeutic Use]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Adult
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Female
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Health Care Surveys
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Humans
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Hypothyroidism/bl [Blood]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Male
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Physicians
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Thyroid Function Tests
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Thyrotropin/bl [Blood]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Thyroxine/bl [Blood]
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Triiodothyronine/bl [Blood]
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Geographic name MedStar Health Research Institute
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Geographic name MedStar Washington Hospital Center
656 ## - INDEX TERM--OCCUPATION
Occupation Medicine/Endocrinology
657 ## - INDEX TERM--FUNCTION
Function Journal Article
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier https://dx.doi.org/10.1089/thy.2018.0369
857 ## -
-- https://dx.doi.org/10.1089/thy.2018.0369
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection code Permanent Location Current Location Date acquired Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 2018-11-09 30375273 2018-11-09 2018-11-09 Journal Article

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