Academic Journal
Indications of over- and undertreatment of hypothyroidism in primary care: a scoping review and evidence mapping.
| Τίτλος: | Indications of over- and undertreatment of hypothyroidism in primary care: a scoping review and evidence mapping. |
|---|---|
| Συγγραφείς: | Sloth BN; Center for General Practice, Aalborg University, Aalborg, Denmark., Blumenfeld MB; Center for General Practice, Aalborg University, Aalborg, Denmark., Kristensen JK; Center for General Practice, Aalborg University, Aalborg, Denmark., Brink Valentin J; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Carlé A; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.; Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark., Thomsen JL; Center for General Practice, Aalborg University, Aalborg, Denmark. |
| Πηγή: | Scandinavian journal of primary health care [Scand J Prim Health Care] 2026 Dec; Vol. 44 (1), pp. 2675694. Date of Electronic Publication: 2026 Jun 06. |
| Τύπος έκδοσης: | Journal Article; Scoping Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Taylor & Francis Country of Publication: United States NLM ID: 8510679 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1502-7724 (Electronic) Linking ISSN: 02813432 NLM ISO Abbreviation: Scand J Prim Health Care Subsets: MEDLINE |
| Imprint Name(s): | Publication: Philadelphia, PA : Taylor & Francis Original Publication: Stockholm, Sweden : Almqvist & Wiksell Periodical Co., [1983- |
| Ιατρικοί όροι (MeSH): | Hypothyroidism*/drug therapy , Hypothyroidism*/diagnosis , Hypothyroidism*/therapy , Overtreatment*/statistics & numerical data , Practice Patterns, Physicians'*/standards , Practice Patterns, Physicians'*/statistics & numerical data , Primary Health Care*/standards , Primary Health Care*/statistics & numerical data , Undertreatment*/statistics & numerical data, Humans ; Guideline Adherence ; Practice Guidelines as Topic |
| Περίληψη: | Introduction: Hypothyroidism is a prevalent endocrine disorder predominantly managed in primary care. Improper treatment can lead to significant clinical and public health consequences. Despite the availability of clear clinical guidelines, over- and undertreatment frequently occur. The aim was to explore and map indications of over- and undertreatment of hypothyroidism in a primary care setting. Methods: We conducted a scoping review guided by Arksey and O'Malley. The search was conducted in PubMed, Embase, CINAHL, Scopus, and the Cochrane Library. We included peer-reviewed studies exploring over- and undertreatment of hypothyroidism in primary care and included both registry/audit and survey studies. Data were extracted across four structured stages, capturing study characteristics and treatment-related outcomes. Data on indications were compared across studies to identify recurring patterns. Results: Nineteen studies were included. The findings show that the majority of studies with larger study populations report a moderate prevalence of over- and undertreatment. Overtreatment was associated with early initiation of therapy, absence of confirmatory testing, and suppressed TSH levels during follow-up. Undertreatment was linked to incomplete diagnostic evaluation, delayed treatment initiation, and inadequate follow-up. Survey studies reported similar patterns of inappropriate management but higher adherence to clinical guidelines. Conclusion: This scoping review found consistent evidence of both over- and undertreatment of hypothyroidism in primary care. A discrepancy between clinicians' reported intentions and observed practice suggests the need to attend to behavioural and organisational factors, and to provide greater support for individualised decision-making to improve care. |
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| Contributed Indexing: | Keywords: Hypothyroidism; general practice; guideline adherence; overtreatment; prescribing patterns; primary care; undertreatment |
| Entry Date(s): | Date Created: 20260606 Date Completed: 20260610 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13244519 |
| DOI: | 10.1080/02813432.2026.2675694 |
| PMID: | 42249773 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1502-7724 |
|---|---|
| DOI: | 10.1080/02813432.2026.2675694 |