A Cross-Sectional Analysis of Cardiovascular and Bone Health Care Utilization During Treatment With Thyroid Hormone
Authors' conclusion
No significant differences in CVD- and BH-related health care utilization were identified between LT4 and DTE/LT4+LT3 users after covariate balancing. Non-MD providers were more likely to prescribe DTE.
Study context
- Population
- Adults (≥18 years) treated with LT4, LT4+LT3 or desiccated thyroid extract (DTE), 2016–2020, Medical Expenditure Panel Survey (US)
- Participants
- 5,437 adults
- Exposure
- DTE or LT4+LT3 vs LT4 monotherapy
- LT4n = 5,106reference
- DTEn = 252
- LT4 + LT3n = 79
- Outcome
- CVD and bone health-related health care utilization (outpatient, emergency and hospital visits for AF, HF, MI, stroke, osteoporosis/fractures, and a composite index)
Methodological detailsmulti-year, weighted analysis (national estimates), propensity score-based matching
- Multi-year
- Weighted analysis (national estimates)
- Propensity score-based matching
Main finding
As reported in the abstract
Combined outpatient CVD and BH-related care utilization (prevalence)
- No differences in emergency/hospital events
- After covariate balancing, cardiovascular disease (CVD) and bone health (BH)-related care utilization similar between groups in outpatient and emergency/hospital settings
- DTE/LT4+LT3 vs LT4: P = 0.008
- Weighted analysis; propensity score-based matching for covariate balancing
Observational data: associations, not effects.
Further findings
Share of thyroid hormone (TH) prescriptions
- LT3 and DTE share of all TH prescriptions
- 7.6%
Provider type for DTE prescriptions
- Nurse practitioners and alternative medicine professionals more likely to be the primary provider type for visits with DTE prescriptions
Original publication
A Cross-Sectional Analysis of Cardiovascular and Bone Health Care Utilization During Treatment With Thyroid Hormone. J Clin Endocrinol Metab. Published 25 October 2023. doi:10.
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