Endocrine Abstracts

Background

The burden of disease in thyroid dysfunction (TD) is modifiable. Social domain of quality-of-life is a vital aspect of the biopsychosocial approach to management. Treatment decisions are increasingly guided by quality-of-life issues, creating a need to monitor the quality-of-life within clinical practice. Thyroid-specific patients reported outcomes scale/tool (ThyPro) was developed and used predominantly in populations in developed countries. Whether this tool can capture the important social domains of quality-of-life in patients with chronic multi-morbid TD in diverse cultures, e.g., South-east Asia, is uncertain. We aimed to compare the findings from our quality-of-life qualitative research project of persons with TD in Malaysia to those in the ThyPro tool study.

Methods

The questionnaires of a Malay language version of the semi-structured qualitative survey in Malaysia, part of the larger research: A CORE OUTCOME SET FOR THYROID DYSFUNCTION¹, were developed from interactive discussions with patients who have thyroid dysfunction. A mixed-method approach was used to collect the data: face-to-face in-depth interviews in the endocrine clinic and online survey using the same set of questionnaires. The responses were analyzed using Braun and Clark’s thematic analysis² framework guided by the question: What are the perceptions and experiences of thyroid care that matter most to patients with TD? The findings were then compared with the items in the ThyPro scale.

Findings

There was no significant difference in the baseline demographic characteristic of our subjects in comparison to the ThyPro cohort (Table 1). The only marked difference is that our study participants have TD of prolonged duration compared with the recent onset in the ThyPro cohort. Major themes that emerged from our analysis are emotional security, functional ability, self-care (including psychosocial and socioeconomic well-being), and quality of physician-patient relationships (Details in Table 2). Symptoms of hyperthyroidism and hypothyroidism impacted upon all the above themes. All the items in the ThyPro scale are present in our cohort. However, health-service factors emerged as an important parameter in our population and are absent from the ThyPro scale.

Conclusion

Our study can capture all the items in patients with recent and chronic TD, unlike the ThyPro scale that captures only outcomes in patients with recent TD. Further robust research is required to determine whether the additional important patient-reported outcomes in populations with varying duration of TD and diverse cultures impact the development of core outcome set for thyroid dysfunction.