Management of hyperthyroidism in Trinidad and Tobago.

A questionnaire study of current practices regarding the investigation and treatment of hyperthyroidism was undertaken in Trinidad and Tobago between December 1999 and March 2000. The study evaluated the choice of laboratory tests requested and the therapeutic choices for a standard patient with hyperthyroidism. In addition, clinical scenarios based upon variations of the standard case (by altering age, gender, goitre size and duration of disease) were also tested. Two hundred and ninety-six questionnaires were sent; 134 (45%) were returned, of which four were excluded for incomplete data. Ninety five per cent of respondents requested biochemical confirmation but the range of tests varied widely. Thyroid scintigraphy was requested by 36% and thyroid ultrasound by 35%. Medical treatment (75%) with antithyroid drugs was the most popular choice for treatment of the standard patient. This did not change significantly if the patient was male. On the other hand, radioiodine (62%) was more popular in the treatment of chronic/relapsing hyperthyroidism (p < 0.005). In the elderly, medical management was still the most popular choice (57%) but the choice of radioiodine therapy was significantly increased compared with that in the standard patient (36% vs 19%) (p<0.005). In a young female with a large goitre and chronic disease, surgical intervention (61%) was the treatment of choice, especially among surgeons and general practitioners; radioiodine was chosen by 28% of respondents (mostly internists). There is need for clear guidelines in investigating thyroid disease but therapeutic choices are well informed and consistent with accepted practice elsewhere. In particular there is a fairly liberal attitude towards radioiodine use in hyperthyroidism.

Hormone replacement therapy. Knowledge, attitudes and practices of women attending a gynaecology outpatient clinic in Trinidad.

A questionnaire was used to assess the knowledge, attitudes, and practices of a sample of 218 outpatients attending the Port of Spain General Hospital Gynaecology Outpatient Clinic. The questionnaire investigated women's knowledge of menopause, risks and benefits of Hormone Replacement Therapy (HRT), their attitudes concerning HRT and menopause as well as practices of postmenopausal women with respect to HRT. Comparisons were made between women of differing menopausal status, educational background and ethnicity. The results showed that overall knowledge was lacking regardless of menopausal status, ethnicity or educational background. Less educated women were more inclined to believe that HRT was inappropriate principally because they regarded the menopause as a natural process (p = 0.023). Only 24% of postmenopausal women were practicing some form of HRT. A minority (7%) had previously been undergoing the therapy but had stopped. Most postmenopausal women (69%) simply never considered treatment because the majority had never heard about HRT. The main source of patient information was from the clinic they were attending. This study reveals low awareness of menopausal information and therapeutic options in a Trinidadian population. A targeted education programme may substantially fill this void.

Hormone replacement therapy. Knowledge, attitudes and practices of women attending a gynaecology outpatient clinic in Trinidad

A questionnaire was used to assess the knowledge, attitudes, and practices of a sample of 218 outpatients attending the Port of Spain General Hospital Gynaecology Outpatient Clinic. The questionnaire investigated women's knowledge of menopause, risks and benefits of Hormone Replacement Therapy (HRT), their attitudes concerning HRT and menopause as well as practices of postmenopausal women with respect to HRT. Comparisons were made between women of differing menopausal status, educational background and ethnicity. The results showed that overall knowledge was lacking regardless of menopausal status, ethnicity or educational background. Less educated women were more inclined to believe that HRT was inappropriate principally because they regarded the menopause as a natural process (p = 0.023). Only 24 of postmenopausal women were practicing some form of HRT. A minority (7) had previously been undergoing the therapy but had stopped. Most postmenopausal women (69) simply never considered treatment because the majority had never heard about HRT. The main source of patient information was from the clinic they were attending. This study reveals low awareness of menopausal information and therapeutic options in a Trinidadian population. A targeted education programme may substantially fill this void.

Hormone replacement therapy - knowledge, attitudes and practices of women attending a gynaecology outpatient clinic in Trinidad

A questionnaire was used to assess the knowledge, attitudes and practices of a sample of 218 outpatients attending the Port of Spain General Hospital Gynaec Outpatient Clinic. The questionnaire investigated women's knowledge of menopause, risks and benefits of Hormone Replacement Therapy (HRT), their attitudes concerning HRT and menopause as well as practices of postmenopausal women with respect to HRT. Comparisons were made between women of differing menopausal status, educational background and ethnicity. The results showed that overall knowledge was lacking regardless of menopausal status, ethnicity or educational background. Less educated women were more inclined to believe that HRT was inappropriate prinicpally because they regarded the menopause as a natural process (p = 0.023). Only 24 percent of postmenopausal women were practicing some from of HRT. A minority (7 percent) had previously been undergoing the therapy but had stopped. Most postmenopausal women (69 percent) simply never considered treatment because the majority had never heard about HRT. The main source of patient information was from the clinic they were attending. This study reveals low awareness of menopausal information and therapeutic options in a Trinidadian population. A targeted education programme may substantially fill this void.(Au)