Endocrine Abstracts

Background and aims: Antithyroid medications are first line treatment for thyrotoxicosis in the UK. The risk of agranulocytosis is ~1:2000 cases. Between 1963 and 2003, 809 adverse reactions related to antithyroid medications were reported. Of these 179 were due to agranulocytosis. Forty-two fatal events were recorded and half of these were related to agranulocytosis.

Patient awareness is vital in preventing drug associated morbidity and mortality. We conducted an audit to assess patient awareness of side effects relating to antithyroid medications.

Methods: An audit cycle was completed over a 2 year period. Patients taking antithyroid medications were given a questionnaire on knowledge of drug side effects. Data was collected over a 3-month period. Recommendations included handing out drug information sheet to patients and face-to-face communication at every clinic opportunity, and re-auditing.

Results: Fifty-four patients completed the questionnaire at the initial audit and 42 patients when repeated. At baseline, 42 patients (85%) were aware of some side effects, 30 patients (55%) were aware of agranulocytosis and 29 patients (53%) stated appropriate action in response to drug side effects. These figures were 86, 71 and 69% respectively after re-auditing. The initial audit found 30% patients remembered being given drug side effect information in clinic, which was more than doubled (69%) in the re-audit.

Conclusion: This audit highlights the importance of a proactive approach from clinicians, supplemented with written information, in raising patient awareness to potentially fatal and avoidable drug adverse events. Targeting other forms of communication such as education groups, media coverage and the internet may help maximise patient understanding.