Evaluation of knowledge levels, behaviors, and medication compliance of hypothyroid patients applying to the Family Medicine Outpatient Clinic regarding levothyroxine use

Hypothyroidism is a chronic disease characterized by a slowdown in metabolism due to the deficiency or ineffectiveness of thyroid hormones. Hypothyroidism, commonly encountered in primary healthcare settings as an endocrine disorder, can lead to significant health problems such as hypertension, dyslipidemia, cognitive impairments, and neuromuscular dysfunction if left untreated. Primary hypothyroidism is 8-9 times more common in women compared to men and increases with age. Levothyroxine (LT4) is an effective standard treatment for hypothyroidism; however, patient adherence to medication significantly influences treatment success. Ensuring medication compliance in chronic diseases is critical to reducing morbidity and mortality rates, as well as healthcare costs. This study aims to evaluate the knowledge levels, behaviors, and medication compliance of hypothyroid patients regarding levothyroxine use at Pamukkale University Faculty of Medicine Family Medicine Outpatient Clinic. This study was designed as a cross-sectional and descriptive research. It was conducted at Pamukkale University Family Medicine Outpatient Clinic between August 1 and November 30, 2024. The study population consisted of hypothyroid patients who applied to the outpatient clinic, and the entire population was targeted without selecting a sample. Inclusion criteria for participation included being 18 years or older, using levothyroxine, and completing the questionnaire fully. Data were collected using questions covering sociodemographic information, statements measuring knowledge about thyroid and thyroid medications, and the Modified Morisky Scale. The data were analyzed using SPSS 25.0 software, with statistical evaluations conducted using both parametric and non-parametric tests. The study included 213 hypothyroid patients with a mean age of 41.11 ± 14.56 years. Of the participants, 86.9% were female, and 39.4% held a university degree. A family history of hypothyroidism was present in 62% of the participants, and 20.2% had undergone thyroid surgery. Among those using levothyroxine, 99.5% took the medication in the morning, and 98.6% took it on an empty stomach. However, only 30.5% correctly knew that there should be at least a 4-hour interval between LT4 and other medications like iron and calcium. While 65.7% of participants showed high motivation in medication use, 87.3% demonstrated a high level of knowledge. Younger age groups and those with higher educational attainment exhibited significantly higher knowledge levels (p<0.05). This study revealed that hypothyroid patients generally have good knowledge about levothyroxine use, though there are notable gaps regarding drug interactions and proper usage intervals. Medication compliance was found to be largely adequate. However, to further improve adherence and address knowledge deficiencies, expanding patient education and informational programs is recommended. Special attention should be given to older individuals and those with lower educational backgrounds to enhance their knowledge. Additionally, raising awareness about drug interactions and ensuring regular patient monitoring could significantly improve treatment outcomes. Keywords: Hypothyroidism, Levothyroxine, Medication compliance, Treatment adherence, Family Medicine.