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Exp Clin Endocrinol Diabetes 2021; 129(12): 918-925
DOI: 10.1055/a-1400-2668
Article

Effects of Treatment Adherence on Quality of Life in Hypoparathyroid Patients

Inan Anaforoglu
1   Bahcesehir University, Faculty of Medicine, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
,
Seda Sancak
2   University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Endocrinology and Metabolism Disorders, Department of Internal Medicine, İstanbul, Turkey
,
Emin Murat Akbas
3   Erzincan Binali Yıldırım University, Mengücek Gazi Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Erzincan, Turkey
,
Guzide Gonca Oruk
4   Izmir Katip Celebi University, Ataturk Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Izmir, Turkey
,
Masum Canat
5   Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
,
Kadriye Aydın Tezcan
6   Kartal Dr. Lütfi Kirdar City Hospital, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
,
Ziynet Alphan Uc
7   Usak Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Usak, Turkey
,
Suheyla Gorar
8   Health Sciences University, Antalya Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Antalya, Turkey
,
Gulhan Cavlak Duman
9   Sivas Cumhuriyet University Health Services Practice and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Adana, Turkey
,
Guzin Fidan Yaylali
10   Pamukkale University Hospitals, Department of Internal Diseases, Endocrinology Clinic, Denizli, Turkey
,
Merve Yılmaz
11   Samsun Gazi State Hospital, Department of Internal Diseases, Endocrinology Clinic, Samsun, Turkey
,
Betul Ekiz Bilir
12   Tekirdag State Hospital, Department of Internal Diseases, Endocrinology Clinic, Tekirdag, Turkey
,
Humeyra Bozoglan
13   Giresun University Prof. Dr. A. Ilhan Ozdemir Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Giresun, Turkey
,
Gulhan Akbaba
14   Mugla Sitki Kocman University Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Mugla, Turkey
,
Mazhar Muslum Tuna
15   Umraniye Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
,
Seckin Akcay
15   Umraniye Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
,
Dilek Tuzun
16   Kahramanmaras Sutcu Imam University Health Practice and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Kahramanmaras, Turkey
,
Gulay Simsek Bagir
17   Baskent University Adana Dr. Turgut Noyan Practice and Research Center, Department of Internal Diseases, Endocrinology Clinic, Adana, Turkey
,
Filiz Eksi Haydardedeoglu
17   Baskent University Adana Dr. Turgut Noyan Practice and Research Center, Department of Internal Diseases, Endocrinology Clinic, Adana, Turkey
,
Gulsah Elbuken
18   Namık Kemal University, Faculty of Medicine, Department of Internal Medicine, Endocrinology Clinic
,
Goknur Yorulmaz
19   Eskisehir Osmangazi University Health, Practice and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Eskisehir, Turkey
,
Ozlem Celik
20   Mehmet Ali Aydınlar Acıbadem University, Faculty of Medicine, Department of Internal Diseases, Endocrinology Clinic, İstanbul, Turkey
,
Murat Topbas
21   Karadeniz Technical University, Faculty of Medicine, Department of Public Health, Trabzon, Turkey
› Author Affiliations Funding This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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Abstract

Objectives This study aimed to evaluate the current situation of hypoparathyroid patients and to investigate the relationship between treatment adherence and quality of life.

Study design Prospective, multicentre study.

Methods Adult patients presenting with the diagnosis of hypoparathyroidism to 20 different endocrinology clinics were included. They were receiving conventional therapies for hypoparathyroidism, using calcium, active vitamin D, and magnesium. We collected data on demographic features, disease- and treatment-related information, and results of routine laboratory tests, treatment adherence, and presence of complications. Beck Depression Inventory, Beck Anxiety Inventory, and Short Form-36 quality of life assessments were administered.

Results Among the 300 patients studied, 60.7% were adherent to their treatment, and 34.1% had complications. Anxiety and depression scores were significantly higher in non-adherent versus treatment-adherent patients (p<0.001 and p=0.001, respectively). Most of the domains of quality-of-life scores were also significantly lower in non-adherent patients. Both anxiety and depression scores showed significant, negative correlations with serum calcium and magnesium concentrations (r=−0.336, p<0.001 and r=−0.258, p<0.001, respectively).

Conclusions Nearly 40% of the patients were non-adherent to conventional treatment for hypoparathyroidism, and such patients had higher anxiety and depression scores and poorer quality of life scores. Conventional treatment might not be sufficient to meet the needs of patients with hypoparathyroidism. In addition to seeking new therapeutic options, factors influencing quality of life should also be investigated and strategies to improve treatment adherence should be developed.

Key words

hypoparathyroidism - conventional treatment - treatment adherence - quality of life


Publication History

Received: 13 November 2020
Received: 20 January 2021

Accepted: 24 February 2021

Article published online:
10 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Cusano NE, Bilezikian JP. Update on hypoparathyroidism. Curr Opin Rheumatol 2019; 31: 381-387
    CrossrefPubMedGoogle Scholar
  • 2 Büttner M, Musholt TJ, Singer S. Quality of life in patients with hypoparathyroidism receiving standard treatment: A systematic review. Endocrine 2017; 58: 14-20
    CrossrefPubMedGoogle Scholar
  • 3 Bilezikian JP. Hypoparathyroidism. J Clin Endocrinol Metab 2020; 105: 1722-1736
    CrossrefPubMedGoogle Scholar
  • 4 Shoback DM, Bilezikian JP, Costa AG. et al. Presentation of hypoparathyroidism: Etiologies and clinical features. J Clin Endocrinol Metab 2016; 101: 2300-2312
    CrossrefPubMedGoogle Scholar
  • 5 Bollerslev J, Rejnmark L, Marcocci C. et al. European Society of Endocrinology. European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol 2015; 173: G1-G20
    CrossrefPubMedGoogle Scholar
  • 6 Rejnmark L. Quality of life in hypoparathyroidism. Endocrine 2018; 59: 237-238
    CrossrefPubMedGoogle Scholar
  • 7 Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-571
    CrossrefPubMedGoogle Scholar
  • 8 Hisli N. Beck depresyon envanteri’nin geçerliliği üzerine bir çalışma. Psikoloji Dergisi 1988; 6: 118-126 [Article in Turkish]
    PubMedGoogle Scholar
  • 9 Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988; 56: 893-897
    CrossrefPubMedGoogle Scholar
  • 10 Ulusoy M, Şahin NH, Erkmen H. Turkish version of the Beck anxiety inventory: Psychometric properties. J Cognit Psychother 1998; 12: 163-172
    PubMedGoogle Scholar
  • 11 Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473-483
    CrossrefPubMedGoogle Scholar
  • 12 Koçyiğit H, Aydemir O, Ölmez N, Memis A. Kısa Form-36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999; 12: 102-106 [Article in Turkish]
    PubMedGoogle Scholar
  • 13 Coles T, Chen K, Nelson L. et al. Psychometric evaluation of the hypoparathyroidism symptom diary. Patient Relat Outcome Meas 2019; 10: 25-36
    CrossrefPubMedGoogle Scholar
  • 14 Brod M, Waldman LT, Smith A, Karpf D. Assessing the patient experience of hypoparathyroidism symptoms: Development of the hypoparathyroidism patient experience scale-symptom (HPES-symptom). Patient 2020; 13: 151-162
    CrossrefPubMedGoogle Scholar
  • 15 Martin S, Chen K, Harris N. et al. Development of a patient- reported outcome measure for chronic hypoparathyroidism. Adv Ther 2019; 36: 1999-2009
    CrossrefPubMedGoogle Scholar
  • 16 Wilde D, Wilken L, Stamm B. et al. The HPQ-development and first administration of a questionnaire for hypoparathyroid patients. JBMR Plus 2019; 7: e10245
    PubMedGoogle Scholar
  • 17 Hadker N, Egan J, Sanders J. et al. Understanding the burden of illness associated with hypoparathyroidism reported among patients in the PARADOX study. Endocr Pract 2014; 20: 671-679
    CrossrefPubMedGoogle Scholar
  • 18 Marcucci G, Cianferotti L, Brandi ML. Clinical presentation and management of hypoparathyroidism. Best Pract Res Clin Endocrinol Metab 2018; 32: 927-939
    CrossrefPubMedGoogle Scholar
  • 19 David K, Moyson C, Vanderschueren D, Decallonne B. Long-term complications in patients with chronic hypoparathyroidism: A cross-sectional study. Eur J Endocrinol 2019; 180: 71-78
    CrossrefPubMedGoogle Scholar
  • 20 Rosa RG, Barros AJ, de Lima AR. et al. Mood disorder as a manifestation of primary hypoparathyroidism: A case report. J Med Case Rep 2014; 8: 326
    CrossrefPubMedGoogle Scholar
  • 21 Arlt W, Fremerey C, Callies F. et al. Well-being, mood and calcium homeostasis in patients with hypoparathyroidism receiving standard treatment with calcium and vitamin D. Eur J Endocrinol 2002; 146: 215-222
    CrossrefPubMedGoogle Scholar
  • 22 Arneiro AJ, Duarte BCC, Kulchetscki RM. et al. Self-report of psychological symptoms in hypoparathyroidism patients on conventional therapy. Arch Endocrinol Metab 2018; 62: 319-324
    PubMedGoogle Scholar
  • 23 Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L. Postsurgical hypoparathyroidism—risk of fractures, psychiatric diseases, cancer, cataract, and infections. J Bone Miner Res 2014; 29: 2504-2510
    CrossrefPubMedGoogle Scholar
  • 24 Astor MC, Løvås K, Debowska A. et al. Epidemiology and health-related quality of life in hypoparathyroidism in Norway. J Clin Endocrinol Metab 2016; 101: 3045-3053
    CrossrefPubMedGoogle Scholar
  • 25 Iqbal K, Dass N, Gip C. et al. Defining the characteristics of chronic hypoparathyroidism not adequately controlled on conventional therapy: Consensus findings of three European Delphi panels. Adv Ther 2019; 36: 3007-3016
    CrossrefPubMedGoogle Scholar
  • 26 Vokes TJ. Quality of life in hypoparathyroidism. Endocrinol Metab Clin North Am 2018; 47: 855-864
    CrossrefPubMedGoogle Scholar
  • 27 Underbjerg L, Sikjaer T, Rejnmark L. Health-related quality of life in patients with nonsurgical hypoparathyroidism and pseudohypoparathyroidism. Clin Endocrinol 2018; 88: 838-847
    CrossrefPubMedGoogle Scholar
  • 28 Hepsen S, Akhanli P, Sakiz D. et al. The effects of patient and disease-related factors on the quality of life in patients with hypoparathyroidism. Arch Osteoporos 2020; 15: 75
    CrossrefPubMedGoogle Scholar
  • 29 Büttner M, Hinz A, Singer S, Musholt TJ. Quality of life of patients more than 1 year after surgery for thyroid cancer. Hormones (Athens, Greece) 2020; 19: 233-243
    CrossrefPubMedGoogle Scholar
  • 30 Sikjaer T, Moser E, Rolighed L. et al. Concurrent hypoparathyroidism is associated with impaired physical function and quality of life in hypothyroidism. J Bone Miner Res 2016; 1: 1440-1448
    CrossrefPubMedGoogle Scholar
  • 31 Siggelkow H, Clarke BL, Germak J. et al. Burden of illness in not adequately controlled chronic hypoparathyroidism: Findings from a 13-country patient and caregiver survey. Clin Endocrinol 2020; 92: 159-168
    CrossrefPubMedGoogle Scholar
  • 32 Khan AA, Koch C, Van Uum SHM. et al. Standards of care for hypoparathyroidism in adults. Eur J Endocrinol 2018; 180: P1-P22
    CrossrefPubMedGoogle Scholar
  • 33 Cusano NE, Rubin MR, McMahon DJ. et al. The effect of PTH(1-84) on quality of life in hypoparathyroidism. J Clin Endocrinol Metab 2013; 98: 2356-2361
    CrossrefPubMedGoogle Scholar
  • 34 Cusano NE, Rubin MR, McMahon DJ. et al. PTH(1-84) is associated with improved quality of life in hypoparathyroidism through 5 years of therapy. J Clin Endocrinol Metab 2014; 99: 3694-3699
    CrossrefPubMedGoogle Scholar
  • 35 Sikjaer T, Rolighed L, Hess A. et al. Effects of PTH(1-84) therapy on muscle function and quality of life in hypoparathyroidism: Results from a randomized controlled trial. Osteoporos Int 2014; 25: 1717-1726
    CrossrefPubMedGoogle Scholar
  • 36 Palermo A, Santonati A, Tabacco G. et al. PTH(1-34) for Surgical hypoparathyroidism: A 2-year prospective, open-label investigation of efficacy and quality of life. J Clin Endocrinol Metab 2018; 103: 271-280
    CrossrefPubMedGoogle Scholar
  • 37 Tabacco G, Tay YD, Cusano NE. et al. Quality of life in hypoparathyroidism improves with rhPTH(1-84) throughout 8 years of therapy. J Clin Endocrinol Metab 2019; 104: 2748-2756
    CrossrefPubMedGoogle Scholar
  • 38 Vokes TJ, Mannstadt M, Levine MA. et al. Recombinant human parathyroid hormone effect on health-related quality of life in adults with chronic hypoparathyroidism. J Clin Endocrinol Metab 2018; 103: 722-731
    CrossrefPubMedGoogle Scholar
  • 39 Winer KK, Does PTH. replacement therapy improve quality of life in patients with chronic hypoparathyroidism?. J Clin Endocrinol Metab 2018; 103: 2752-2755
    CrossrefPubMedGoogle Scholar