- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05314790
Management of Patients With Diagnosis of Hypothyroidism, as Hospitalized and as Outpatients, in Internal Medicine Units: Observational Study Before & After Educational Programme (TIAMO)
There is still limited knowledge regarding the clinical profile and appropriateness of treatment in patients with hypothyroidism hospitalized in Internal Medicine (IM) Departments in Italy. The aim of this study is to evaluate: 1) the characteristics of patients and possible deviations from national and international clinical practice recommendations (CPRs) in evidence-based guidelines (EBGs); 2) the improvement of patient management by means of a standardized educational programme (EP).
Methods: A nationwide multicentre study, comprising two replications of a retrospective survey (phases 1 and 3) with an intervening EP (phase 2) in half of the centres and no EP in the other half, was conducted. The EP was based on outreach visits. Centres were assigned to the two arms of the study, labelled the training group (TG) and control group (CG) respectively, by cluster randomization.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Hypothyroidism (HT) is a common disorder that affects more than 4% of the general population. Since this percentage does increase with advancing age, it is reasonable to suppose that hypothyroidism is becoming a widespread disease condition. Furthermore hypothyroidism is correlated with significant cardiovascular morbidity and mortality.
Although the potential clinical impact of hypothyroidism, the clinical profile of patients affected by hypothyroidism and managed in the Internal Medicine setting it is not very well known so far. This study has the aim to take a real-life picture of Internal Medicine patients with diagnosis of hypothyroidism, in order to evaluate possible deviations between the current clinical practice and the evidence-based guidelines, and possibly improving the management by means of an educational program.
The FADOI-TIAMO study is designed as a replicate of two cross-sectional surveys (Phase 1 and 3) interspersed with an educational program (Phase 2) to be conducted in 11 out of the 22 participating Centres. The data collection in Phases 1 and 3 will be based on the review of medical records of the last 30 consecutive patients with known or de novo diagnosis of HT observed in each Centre (globally, 1200 patients).
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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-
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Belluno, Italy
- ULSS1 Belluno San Martino
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Camaiore, Italy
- Ospedale Versilia
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Canicattì, Italy
- Ospedale di Canicattì
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Castiglione Del Lago, Italy
- Ospedale di Castiglione del Lago, Medicina del Trasimeno
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Catania, Italy
- Garibaldi Nesima
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Forlì, Italy
- Ospedale G.B. Morgagni - P.L. Pierantoni
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Ghilarza, Italy
- Ospedale G.P. Delogu
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Gubbio, Italy
- Ospedale Gubbio-Gualdo Tadino
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Isernia, Italy
- Ospedale "F. Veneziale"
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Latina, Italy
- ASL Latina
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Massa Marittima, Italy
- Ospedale S. Andrea
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Moncalieri, Italy
- Ospedale S. Croce di Moncalieri - ASL TO5
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Napoli, Italy
- Ospedale del Mare
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Napoli, Italy
- Ospedale Fatebenefratelli
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Novara, Italy
- Ospedale Maggiore di Novara
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Palermo, Italy
- Ospedale Civico di Partinico
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Reggio Calabria, Italy
- Ospedale "Bianchi-Melacrino-Morelli"
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San Giovanni Rotondo, Italy
- Casa Sollievo della Sofferenza
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Sassari, Italy
- AOU di Sassari
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Savona, Italy
- Ospedale San Paolo
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- known diagnosis of hypothyroidism on the basis of medical history or laboratory results, as indicated in the clinical record of inpatients admitted to the IM department for any condition
Exclusion Criteria:
- none
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
control group (CG)
Without intervening Educational Program
|
|
training group (TG)
Group who has received an Educational Program (EP).
The implementation of an EP based on meetings within the Department, coordinated by an outside tutor (outreach visit model).
The EP content was defined beforehand by a Scientific Board, on the basis of evidence-based guidelines (EBGs) and an up-to-date literature review, but also with a specific focus on any departures from standard clinical practice recommendations (CPRs) identified at each IM department in phase 1.
|
The implementation of an EP is based on meetings within the Department, coordinated by an outside tutor (outreach visit model).
The EP content was defined beforehand by a Scientific Board, on the basis of evidence-based guidelines (EBGs) and an up-to-date literature review, but also with a specific focus on any departures from standard clinical practice recommendations (CPRs) identified at each IM department in phase 1;
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To evaluate any possible offset between treatment standards for hypothyroidism and the real-life management of patient
Time Frame: 4 months for each phase
|
To evaluate, in the real-life management of the hypothyroidism therapy, possible deviations from national and international clinical practice recommendations (CPR) in evidence-based guidelines (EBGs).
Four EBGs and 39 CPRs have provided the basis on which 22 treatment management indicators have been identified (e.g.
Number of Patients on LT4 replacement therapy who are not taking oral solution or softgel formulations are on absorption-hindering medication and/or do not comply with timing in relation to meals / Number of patients on LT4 replacement therapy who do not comply with the prescribed timing before meals and/or are taking absorption-hindering medication; Number of patients on replacement therapy with TSH in the ATA target range/ Number of patients on replacement therapy with known TSH; Number of patients on replacement therapy, taking LT4 tablets at least 60' before breakfast or at least 3 h after dinner / Number of patients on replacement therapy with LT4 tablets)
|
4 months for each phase
|
Effects of an educational programme
Time Frame: 4 months for each phase
|
To evaluate the improvement of some indicators (the same of outcome 1) in the management of patients with hypothyroidism by means of a standardized educational programme (e.g.
Number of Patients on LT4 replacement therapy who are not taking oral solution or softgel formulations are on absorption-hindering medication and/or do not comply with timing in relation to meals / Number of patients on LT4 replacement therapy who do not comply with the prescribed timing before meals and/or are taking absorption-hindering medication; Number of patients on replacement therapy with TSH in the ATA target range/ Number of patients on replacement therapy with known TSH; Number of patients on replacement therapy, taking LT4 tablets at least 60' before breakfast or at least 3 h after dinner / Number of patients on replacement therapy with LT4 tablets)
|
4 months for each phase
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical profile evaluation of hypothyroidism
Time Frame: 4 months for each phase
|
Assessment of age, gender, weight, hormonal hypothyroidism status (TSH, FT3, FT4), comorbidity, treatment of hypothyroidism and other pharmacological therapies of patients with hypothyroidism
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4 months for each phase
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- FADOI.05.2015
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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