Concurrent Use of Thyroid Hormone Therapy and Interfering Medications in Older US Veterans.
J Clin Endocrinol Metab
; 107(7): e2738-e2742, 2022 06 16.
Article
en En
| MEDLINE
| ID: mdl-35396840
ABSTRACT
CONTEXT Thyroid hormone management in older adults is complicated by comorbidities and polypharmacy. OBJECTIVE:
Determine the prevalence of concurrent use of thyroid hormone and medications that can interfere with thyroid hormone metabolism (amiodarone, prednisone, prednisolone, carbamazepine, phenytoin, phenobarbital, tamoxifen), and patient characteristics associated with this practice.DESIGN:
Retrospective cohort study between 2004 and 2017 (median follow-up, 56 months).SETTING:
Veterans Health Administration Corporate Data Warehouse.PARTICIPANTS:
A total of 538 137 adultsâ ≥â 65 years prescribed thyroid hormone therapy during the study period. MAIN OUTCOMEMEASURE:
Concurrent use of thyroid hormone and medications interfering with thyroid hormone metabolism.RESULTS:
Overall, 168 878 (31.4%) patients were on at least 1 interfering medication while on thyroid hormone during the study period. In multivariable analyses, Black/African-American race (odds ratio [OR], 1.25; 95% CI, 1.21-1.28, compared with White), Hispanic ethnicity (OR, 1.12; 95% CI, 1.09-1.15, compared with non-Hispanic), female (OR, 1.11; 95% CI, 1.08-1.15, compared with male), and presence of comorbidities (eg, Charlson/Deyo Comorbidity Scoreâ ≥â 2; OR, 2.50; 95% CI, 2.45-2.54, compared with 0) were more likely to be associated with concurrent use of thyroid hormone and interfering medications. Older age (eg, ≥ 85 years; OR, 0.48; 95% CI, 0.47-0.48, compared with age 65-74 years) was less likely to be associated with this practice. CONCLUSIONS AND RELEVANCE Almost one-third of older adults on thyroid hormone were on medications known to interfere with thyroid hormone metabolism. Our findings highlight the complexity of thyroid hormone management in older adults, especially in women and minorities.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Veteranos
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Aged
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Female
/
Humans
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Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos