Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2010) 21 P381

SFEBES2009 Poster Presentations Thyroid (45 abstracts)

Do we warn patients about the risk of neutropenia associated with the use of anti-thyroid drugs?

Muhammad Butt , Itopa Abedo , Fong Chau & Andrew Johnson


Southmead Hospital, Bristol, UK.


Audit standard: All patients should receive written and verbal advice about the risk of neutropenia associated with the use of anti-thyroid drugs. Compliance rate 100%.

Our Endocrinology Department has a detailed patient information sheet that is provided to the patients at the time of initiation of anti-thyroid drugs.

Background: Recently, a patient was admitted with neutropenia secondary to the use of carbimazole. She did not know about the risk of neutropenia associated with the use of anti-thyroid drugs. This raised doubts as to whether we adhere to our standards. To answer this question, we undertook this audit to determine if we were meeting our standards.

Methods: We retrospectively reviewed the clinic letters and notes of all new patients who were seen in our endocrine clinics between January and December 2008 (n=69) and prescribed anti-thyroid drugs.

Results: Anti-thyroid drugs were started by the general practitioners in 50 patients (72%) and by the endocrinologists in 14 patients (21%). It was not possible to identify where anti-thyroid drugs were started in five patients (7%). Neutropenia advice was documented in clinic letters and notes in 30 (43%), and 18 patients (26%) respectively following their first clinic appointment. There was no documentation of neutropenia advice in clinic letters and notes in 21 patients (30%). In 18 patients (19%), there was no documentation of advice either in clinic letters or notes even after their third clinic appointment.

Conclusion: Our audit confirms poor documentation of neutropenia advice in both clinic letters and notes.

Action plan: 1. We have developed a system with the help of IT department that allows our secretaries to automatically add the warning information into the clinic letters whilst typing.

We have prepared a medic-alert card that is given to all patients during their first consultation. This card provides them precise information about the side effects of anti-thyroid drugs and actions to undertake should they experience any side effects.

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