Bocale Raffaella, Desideri Giovambattista, Barini Angelina, D'Amore Annamaria, Boscherini Mauro, Necozione Stefano, Lombardi Celestino Pio
Division of Endocrine Surgery, "Agostino Gemelli" School of Medicine, University Foundation Polyclinic, Catholic University of the Sacred Heart, 00198 Rome, Italy.
Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
J Clin Med. 2022 Jul 24;11(15):4296. doi: 10.3390/jcm11154296.
(1) Background: We evaluated the long term adherence to two distinct formulations of levothyroxine (L-T4), liquid or solid, which are differently influenced by concomitant food ingestion. (2) Methods: A total of 106 thyroidectomized patients (82 female, mean age 58.2 ± 13.3 years) on L-T4 replacement therapy in either liquid (n = 52) or solid formulation (n = 54) were administered the four-item Medication Adherence Questionnaire (MAQ). (3) Results: The study population had 59.4% adherers and 40.6% non-adherers. The global MAQ score was significantly better in patients under liquid L-T4 in comparison to those under solid L-T4 (0.42 ± 0.82 vs. 0.83 ± 0.95, respectively, p = 0.0085). The patients on tablet L-T4 forgot to take their medication more frequently than those on liquid LT4 treatment (p = 0.0159) and were more often careless at times about taking their medication (p = 0.007), whilst about one in two thyroidectomized patients preferred tablets for lifetime medication therapy. The global MAQ score was directly correlated with the circulating TSH levels in the whole study population (0.700, p < 0.0001) and inversely correlated with both the FT3 (−0.220, p = 0.0232) and FT4 (−0.327, p = 0.0006) serum concentrations. (4) Conclusions: Long-term adherence to L-T4 treatment was globally satisfactory although it was better for the liquid formulation, which appears to represent an easier-to-manage L-T4 replacement therapy for most thyroidectomized patients, particularly for those with difficulties in taking L-T4 while fasting.
(1) 背景：我们评估了左甲状腺素（L-T4）两种不同剂型（液体或固体）的长期依从性，这两种剂型受同时摄入食物的影响不同。(2) 方法：共有106例接受L-T4替代治疗的甲状腺切除患者（82例女性，平均年龄58.2±13.3岁），其中52例使用液体剂型，54例使用固体剂型，对他们进行了四项用药依从性问卷（MAQ）调查。(3) 结果：研究人群中依从者占59.4%，非依从者占40.6%。与使用固体L-T4的患者相比，使用液体L-T4的患者MAQ总体得分明显更高（分别为0.42±0.82和0.83±0.95，p = 0.0085）。服用片剂L-T4的患者比服用液体L-T4的患者更频繁地忘记服药（p = 0.0159），并且在服药时更经常粗心大意（p = 0.007），而约二分之一的甲状腺切除患者终身药物治疗更喜欢片剂。在整个研究人群中，MAQ总体得分与循环TSH水平直接相关（0.700，p < 0.0001），与FT3（-0.220，p = 0.0232）和FT4（-0.327，p = 0.0006）血清浓度呈负相关。(4) 结论：L-T4治疗的长期依从性总体上令人满意，尽管液体剂型更好，对于大多数甲状腺切除患者来说，液体剂型似乎是一种更易于管理的L-T4替代疗法，特别是对于那些在禁食时服用L-T4有困难的患者。
