The European journal of general practice · 2025
On the way to deprescribing levothyroxine in subclinical hypothyroidism in general practice - the patients' perspective of enablers and barriers.
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Rennert M, Geier A K, Christ L, Hager S, Scheibe S, Rettich A, Schübel J, Deutsch T, Bleckwenn M, Voigt K
Аннотация
BACKGROUND: Recent studies indicate that the synthetic thyroid hormone levothyroxine (LTX) in many cases has no beneficial effects on patients with subclinical hypothyroidism. Still, prescriptions are increasing worldwide. If there is no clear indication for treatment, patients treated with LTX should be offered a deprescribing trial according to current guidelines. However, there is currently no protocol for deprescribing LTX in primary care.
OBJECTIVES: We aimed to explore patients' enablers and barriers towards deprescribing levothyroxine in primary care to inform the further participatory development of a deprescribing strategy.
METHODS: Based on the COREQ checklist, focus group discussions were conducted with patients and general practitioners as well as patients only in 2024. Participants ranked the five most crucial enablers and barriers. Transcripts and prioritised elements were examined using the qualitative content analysis method according to Kuckartz.
RESULTS: Patients frequently felt misinformed about their condition and the prescription of LTX. A change in their medications raised doubts and uncertainties. However, the potential advantages and opportunities of deprescribing were compelling: a (re)gain of quality of life, a decrease in probable drug side effects, savings of time and cost. Mostly, patients welcomed a gradual and managed deprescribing under their general practitioner's supervision.
CONCLUSION: Patients wished for medical information to reduce their doubts concerning deprescribing and expressed confidence in their general practitioner. Our findings indicate a fundamental commitment to deprescribing LTX. For an adherent process in general practitioners' practices, a strategy that considers patients' worries and concerns seems feasible.
OBJECTIVES: We aimed to explore patients' enablers and barriers towards deprescribing levothyroxine in primary care to inform the further participatory development of a deprescribing strategy.
METHODS: Based on the COREQ checklist, focus group discussions were conducted with patients and general practitioners as well as patients only in 2024. Participants ranked the five most crucial enablers and barriers. Transcripts and prioritised elements were examined using the qualitative content analysis method according to Kuckartz.
RESULTS: Patients frequently felt misinformed about their condition and the prescription of LTX. A change in their medications raised doubts and uncertainties. However, the potential advantages and opportunities of deprescribing were compelling: a (re)gain of quality of life, a decrease in probable drug side effects, savings of time and cost. Mostly, patients welcomed a gradual and managed deprescribing under their general practitioner's supervision.
CONCLUSION: Patients wished for medical information to reduce their doubts concerning deprescribing and expressed confidence in their general practitioner. Our findings indicate a fundamental commitment to deprescribing LTX. For an adherent process in general practitioners' practices, a strategy that considers patients' worries and concerns seems feasible.