Endocrine Abstracts

Aim: The aim of our study was to explore the possibility of using a district-wide laboratory database as a governance tool to ensure the optimum management of patients with biochemical hyperthyroidism.

Patients and methods: A complete list of patients on whom TFT were requested over a 3-month period was obtained and patients with unequivocal hyperthyroidism were identified. General practitioners (GP) of patients not referred to the specialist endocrine team during the preceding 6 months were sent a standard letter. The letter provided information on the test result and made a recommendation to seek specialist opinion. For patients in whom referral could not be made, the reason for non-referral was sought and appropriate advice was provided to achieve euthyroid state.

Results: Three hundred and forty-seven TFT were requested over a 3-month period of which 88 patients were hyperthyroid. Of 59 (67%) patients had either attended or were waiting to attend endocrine appointment while 29 (33%) patients had not been referred to endocrine team and were sent the standard letter. No response was received for 11 patients and responses received for the remaining 18 patients were as follows – five were referred to endocrine team, seven were on thyroxine with readjustment of its dose after receiving the letter, three were attending another local clinic and three were being managed in the primary care due to comorbidity. Of 3/29 patients had persistent hyperthyroidism at the end of 3 months after the initial TFT and for two of these patients no response had been received to the standard letter.

Conclusions: A regular audit of the laboratory database provides an excellent opportunity for specialist endocrine team to oversee optimal management of patients with hyperthyroid biochemistry and can form an excellent tool for district-wide endocrine governance process.