WONCA 2013 oral presentation Daniela Florentina Pruteanu Carmen Blanco Villar Noelia Pastor Gradoli

2. Our health care centre (HCC) is placed in a semi-urban
region, it has 13 GP surgeries and 4 paediatric surgeries.
It takes care of a population of about 25,000 inhabitants
In 2012 we registered 112,000 visits
Mean daily number of patients: 36
INTRODUCTION
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3. Assessment of the underactive thyroid
patients in a general practice surgery (GP) of a
Health Care Centre (HCC)
OBJECTIVE
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4. Exclusion criteria:
•Diagnosis established in 2012
•Patients who did not attended their GP surgery in the last 18
months
•Exclusion from the local public health insurance, death, patients
lost from follow up because change in their place of living.
Subjects: underactive thyroid patients (N=160) of a GP
surgery of our HCC (Quart de Poblet).
Evaluated period: 2011-2012.
Data: extracted from electronic medical records and
have been processed using 15.0 SPSS software.
METHODOLOGY
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5. 2011 2012
Variables
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METHODOLOGY

6. Mean age: 56.2 years (SD 17.4).
BMI (N=65): 31.07 (SD 5.55).
GENDER DISTRIBUTION
81.2%
18.8%
Females Males
TYPE OF HYPOTHYROIDISM
91.9
8.1
Clinical H. Subclinical H.
RESULTS
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7. 3.83
4.09
3.04
1.27
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
TSH T4
2011 2012
Thyroid hormone levels (mg/dL)
RESULTS
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8. Annual number of thyroid hormone determinations
0
10
20
30
40
50
60
70
0 1 2 3 4 5
15.6
61.3
17.5
4.4
0.6 0.6
21.3
57.5
18.8
1.9 0 0.6
2011 2012
0
10
20
30
40
50
60
0 1 2 3 4 5
20.6
57.5
16.9
3.8
0.6 0.6
24.4
57.5
16.3
1.3 0 0.6
2011 2012
Percentage Percentage
Number of TSH determinations Number of T4 determinations
RESULTS
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9. Lipid profile mean values (mg/dl)
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RESULTS

10. Associated mental health
diagnosis
Absolute number
of patients
Percentage of
total sample
Anxiety 39 24.4
Depression 11 6.9
Anxiety and depression 16 10
Total 66 41.3
RESULTS
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11. RESULTS

12. Patients with clinical h. and high
TSH (>5.5 mg/dL)
Number of patients Percentage of
patients
Treatment change in 2011 1 3.7
Treatment change in 2012 11 40.7
Treatment change in 2011 and in
2012
2 7.4
No treatment change in the
assessed period
13 48.1
Total 27 100
Therapeutic inertia
RESULTS
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13. 1. There is a high percentage of well controlled hypothyroidism
patients (83.1%).
2. More than 40% of the patients associate depression and / or anxiety.
4. A periodical assessment would help diminish the therapeutic intertia,
improve the control of high and very high cardiovascular risk and
diminish the number of endocrinology referrals of subclinical
hypothyroidism patients.
3. Poor BMI registration in the EMR (only in 40% of
the patients).
CONCLUSIONS
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