Machado-Alba Jorge, Valencia-Marulanda Jhon, Jiménez-Canizales Carlos, Salazar Victoria, Romero Diego
Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia,
Rev Panam Salud Publica. 2014 Aug;36(2):80-6.
Determine thyroid hormone prescription patterns in the population covered by the Colombian Social Security Health System.
Descriptive study using a database of 6.2 million people. The selected patients, men and women of all ages, received continuous thyroid hormone treatment from April to June 2013. A database on medication use was designed, using data obtained by the company that dispenses these drugs.
It was found that 29 947 patients in 82 Colombian cities had been treated for hypothyroidism. The majority (79.1%) were women, with an average age of 63.2 ± 16.1 years. The most common prescription was for levothyroxine in 50 µg tablets (85.7%) at higher-than-recommended daily dosages, especially as monotherapy. Significant differences between age groups and cities of residence were found for the combined use of thyroid hormone and co-medication. The most frequently prescribed concomitant drugs were antiulcer agents (44%), hypoglycemics (17.4%), and iron salts (16.1%).
There are significant differences in prescribing practices in the cities studied. Clinical management guidelines that standardize dosages and physicians' practices are needed, since a lack of guidelines has likely had an impact on patients' health. The clinical efficacy of the prescriptions studied should be explored.
确定哥伦比亚社会保障卫生系统覆盖人群中的甲状腺激素处方模式。
采用描述性研究，使用一个包含620万人的数据库。所选患者为各年龄段的男性和女性，于2013年4月至6月接受持续甲状腺激素治疗。利用分发这些药物的公司获取的数据，设计了一个用药数据库。
发现哥伦比亚82个城市的29947名患者接受了甲状腺功能减退症治疗。大多数（79.1%）为女性，平均年龄为63.2±16.1岁。最常见的处方是50μg片剂的左甲状腺素（85.7%），日剂量高于推荐剂量，尤其是作为单一疗法。在甲状腺激素与联合用药的联合使用方面，年龄组和居住城市之间存在显著差异。最常开具的伴随药物是抗溃疡药（44%）、降糖药（17.4%）和铁盐（16.1%）。
在所研究的城市中，处方做法存在显著差异。需要制定标准化剂量和医生做法的临床管理指南，因为缺乏指南可能对患者健康产生了影响。应探索所研究处方的临床疗效。
