Endocrine Abstracts

Background: Close follow up of patients treated with radioiodine (RAI) for hyperthyroidism is imperative to ensure that resultant hypothyroidism or ensuing hyperthyroidism is detected promptly and treated. Protocols of follow up vary between hospitals. In our centre, a telephone clinic is used and patients are called after thyroid function tests at 1, 3, 6, 9 and 12 weeks post radioiodine.

Aims: To audit patient follow up in the telephone clinic, comparing this with follow up in the traditional outpatient clinic.

Methods: An audit of 90 patients followed up in the telephone clinic was compared to an audit of 87 patients followed up in outpatient clinics at two other hospitals. Dates and results of thyroid functions tests were noted. For those who required thyroxine, the date of commencement was recorded. To assess the clinical implication of a delay in thyroxine replacement, weight change pre- to post-RAI was calculated.

Results: In the telephone clinic, 95% of patients had a blood test 3 weeks post-RAI; these patients had their first blood test earlier (mean first blood test in the telephone clinic 15.5±7.94 days compared to 37.7±39.17 days in the outpatient clinic; P<0.01). Mean TSH at thyroxine commencement was 7.68±13.98 mU/l in those patients in the telephone clinic compared to 29.74±30.20 mU/l in the outpatient clinic (P<0.01). There was no difference in mean weight change amongst the two groups (mean weight change in the telephone clinic was 2.42±4.12 kg, compared to 2.30±4.24 kg in the outpatient clinic; P=0.84).

Conclusions: Use of a telephone clinic allows earlier and more frequent monitoring of patients. Patients are therefore less biochemically hypothyroid prior to commencement of thyroxine. Further work is needed to assess the clinical implications of these results.