Adequacy of thyroid hormone replacement for people with hypothyroidism in real‐world settings: A systematic review and meta‐analysis of observational studies
Authors' conclusion
On average, approximately half of patients with hypothyroidism are only treated to target euthyroidism. In real-world practice, a significant number of patients are over-treated or under-treated, leading to adverse healthcare outcomes. It is imperative that more effective thyroid monitoring strategies be implemented, with an emphasis on primary care thyroid function monitoring, to minimise inappropriate thyroid replacement treatments and optimise healthcare outcomes at a population level.
Study context
- Population
- Patients with known hypothyroidism on thyroid hormone replacement in real-world settings, excluding thyroid hormone suppressive therapy for thyroid cancer
- Participants
- 4,230 patients7 studies
- Outcome
- Pooled prevalence of adequate thyroid hormone replacement, over-replacement and under-replacement
Methodological detailsJoanna-Briggs appraisal tool for prevalence studies, Embase, Medline, PubMed and SCOPUS searched until 12 December 2022
- Joanna-Briggs appraisal tool for prevalence studies
- Embase, Medline, PubMed and SCOPUS searched until 12 December 2022
Pooled result
As reported in the abstract
Adequate replacement
0.55
95% CI 0.49–0.60p = .001
Over-replacement
0.20
95% CI 0.14–0.27p = .001
Under-replacement
0.24
95% CI 0.13–0.36p = .001
Further pooled results
Pooled prevalence of overt and subclinical hyper- and hypothyroidism
- Overt hyperthyroidism
- 0.04 (95% CI 0.00-0.11, p = .01)
- Subclinical hyperthyroidism
- 0.17 (95% CI 0.09-0.27 p = .001)
- Overt hypothyroidism
- 0.02 (95% CI 0.01-0.03, p = .001)
- Subclinical hypothyroidism
- 0.20 (95% CI 0.12-0.29, p = .001)
- 4 studies
Original publication
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