| Abstract [eng] |
Background: The use of levothyroxine is increasing every year. Pharmacists are often the first to identify errors in patients’ LT4 use and can provide important information about medication regimens and potential interactions. However, there is a lack of studies evaluating pharmacists’ knowledge of factors limiting LT4 absorption and the frequency of related patient counseling. Aim of the study: To determine pharmacists’ awareness, knowledge, attitudes, and practices regarding factors interfering with levothyroxine absorption, and to assess the pharmacist’s role in informing patients about proper LT4 use. Objectives: 1. To assess pharmacists’ awareness and knowledge of factors interfering with LT4 absorption and their views on the importance of these factors. 2. To identify pharmacists’ counseling practices for patients with hypothyroidism. 3. To assess pharmacists’ readiness to counsel patients on proper LT4 use. Study method: A cross-sectional quantitative study was conducted using an anonymous 26-item questionnaire consisting of 5 open-ended and 21 closed-ended questions. The questionnaire assessed pharmacy professionals’ awareness, knowledge, attitudes, and practices regarding LT4 and factors affecting its absorption. Results: The study included 228 pharmacy professionals: 86.8% (n=198) pharmacists and 13.2% (n=30) pharmacy technicians. Most respondents correctly identified major factors reducing LT4 absorption: milk and dairy products (90.4%), long-term PPI use (69.7%), atrophic gastritis (80.7%), Helicobacter pylori infection (75.4%), and polypharmacy (72.8%). Respondents agreed that even minor interactions between medications, supplements, and food may have clinical significance in hypothyroidism treatment, and that informing patients about LT4 interactions helps prevent treatment failure (98.25%). A statistically significant association was found between the most appropriate practical solution selected and pharmacists’ work experience. Pharmacy professionals felt most confident counseling patients about LT4 interactions visible in the e-prescription system (6.64±1.52) and proper LT4 use (6.57±1.28), while they felt least confident collaborating with physicians regarding potential LT4 interactions (5.40±1.79). Conclusions: 1. Pharmacy professionals demonstrate good knowledge of basic LT4 interactions, but insufficient knowledge regarding specific medical conditions. 2. Respondents consider the pharmacist’s role and active involvement in patient care important, although they are uncertain whether counseling on LT4 treatment duration is their responsibility. 3. Greater work experience did not determine selection of the most appropriate practical solution regarding LT4 compatibility with other medications. 4. Pharmacy professionals felt most confident counseling patients about LT4 interactions visible in the e-prescription system, but least confident collaborating with physicians regarding potential LT4 interactions. 5. The main barriers complicating LT4 counseling include lack of interdisciplinary collaboration, patients’ preconceived beliefs, and complex interactions between LT4, medications, and dietary supplements. Keywords: Levothyroxine; absorption; pharmaceutical counseling; drug interactions. |
