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Hypothyroidism (THY) QOF tips

Tips for improving QOF scores in this area and current indicators for 2013/14.

Goitre (swelling) of the neck in a patient with Hashimoto's thyroiditis (Picture: SPL)
Goitre (swelling) of the neck in a patient with Hashimoto's thyroiditis (Picture: SPL)

Tips for improving achievement

British Thyroid Foundation director Janis Hickey says GPs must 'listen to the patient and their symptoms'.  'Acknowledge the impact these symptoms have on their wellbeing, even where you are satisfied that thyroid function has been restored to normal levels as measured by thyroid function tests,' she says.

'Enable the patient to manage their condition better by explaining how thyroid function tests work and the importance of regular testing. Once the thyroid is stable the patient should be invited for a test every twelve to fifteen months. Remember the objective is to restore the patient to good health and not just to get the thyroid function test results to the midway points of the reference range.'

British Thyroid Foundation development officer Julia Priestley says GPs must take responsibility for giving patients their test results and to explain the results, rather than leaving it to receptionists to pass on the information.

'This will provide an opportunity to give the patient follow up advice,' she says. 'For instance if there is a "normal"  thyroid function test, but ongoing symptoms, the next step may be "fine-tuning" the levothyroxine levels, further tests in the case of sub-clinical hypothyroidism, or perhaps the need to look for something else if the symptoms persist,' she says.

British Thyroid Foundation volunteer Vivienne Rivis says it is important to remember that thyroid function must kept within the normal range  before, during and after pregnancy. 'Hypothyroid patients wanting to become pregnant, and women with a history of thyroid disorders in the family, should be tested pre-conception to ensure their thyroid function tests are at the correct levels,' she says.

She says GPs must also be open minded. 'Thyroid disorders can affect anyone,' she says. 'The majority of hypothyroid patients are likely to be women but children and men may also be affected. Typical thyroid symptoms should not be ignored because the patient’s profile doesn’t fit that of a classic hypothyroid person.'

Current indicators

Hypothyroidism (THY) indicators Points Achievement thresholds (all UK countries)

THY001: The contractor establishes and maintains a register of patients with hypothyroidism who are currently treated with levothyroxine.

1

 

THY002: The percentage of patients with hypothyroidism, on the register, with thyroid function tests recorded in the preceding 12 months (15 months in Wales and N Ireland).

6

50-90%


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