Endocrine Abstracts

Background: Thyrotoxicosis may be associated with considerable patient morbidity. Graves’ disease (GD) and toxic multinodular goitre (TMNG) are the most common causes of thyrotoxicosis. Therapeutic options include anti-thyroid medication or definitive treatment by radioiodine or surgery. Efficacy, quality of life and cost-effectiveness are among the outcomes that have been compared between these two therapies. However, there is still no clear consensus as to which treatment option offers a better outcome.

Aims: The aim of this study was to assess quality of life amongst patients who received anti-thyroid medication, radioiodine or surgery and to assess patient satisfaction with the treatment modality selected.

Method: Participants in a prospective study with new onset thyrotoxicosis were invited to participate. Those who agreed to be involved completed a questionnaire detailing factors involved in treatment choice, quality of life (ThyPRO) and satisfaction with their treatment.

Results: Of those eligible for the study 146 patients completed the questionnaires, representing a return rate of 73%. GD was the cause of the thyrotoxicosis in 84% and TMNG in 16%. Fifty-eight percent of patients had received anti-thyroid medication, 19% radioiodine, and 22% thyroid surgery, the latter two groups usually following a period of medical therapy. The impact of treatment on recovery time, activities of daily living, possibility of depression or anxiety, and doctor’s recommendations were identified as the most important factors in choosing a treatment. Satisfaction levels were high across all three treatment types. There was no difference in quality of life between the treatment types apart from a higher score for cosmetic concerns in the surgical group.

Conclusions: These results indicate that overall patient satisfaction with treatment and quality of life are comparable across all three treatment options. Therefore, factors such as patient preference and resource availability may be more important than treatment type.