Pharmacist-Mediated Thyroid-Stimulating Hormone (TSH) Test Guideline Monitoring Program- Outcomes of a Retrospective Study In Patients On Levothyroxine

Abstract

Thirty to sixty percent of individuals taking levothyroxine were either under or overtreated, which leads to organ damage and excess mortality. This study aims to assess the gaps in the “thyroid-stimulating hormone (TSH) test guideline compliance rate” and validate the scope of ambulatory care pharmacist-mediated practice in patients on levothyroxine. At the study site, pharmacists offered patient-centered telephonic counseling to patients on levothyroxine who had been non-compliant with TSH tests for more than a year. A two-month quantitative retrospective analysis of this practice was conducted to assess its impact on TSH lab test adherence and dose modification outcomes. 415 patients met the study’s inclusion criteria who received pharmacist counseling with documented intervention. Pharmacists bridged the significant gap in practice by creating new TSH lab requests with counseling in 81.2% (n = 337) of the study population who did not have TSH lab requests prior to the program. The non-compliance rate population dropped from 79.27% (n = 329) to 17.59% (n = 73) in the study population who had been non-compliant with the TSH test for 13 and 24 months. 74.5% (n = 309) were found to have performed their TSH test after the pharmacist’s intervention. Among 100, 66% (n = 66) patients with abnormal TSH values consulted their physician for advice, of which 60.6% (n=40) had their levothyroxine dose adjusted (χ2=82.702, P < 0.01. The study suggests that pharmacists can significantly mediate between patients and physicians to enhance TSH test compliance and essential dose adjustment in patients prescribed levothyroxine.