Prevalence of treated hypothyroidism in the community: Analysis from general practices in North-East England with implications for the United Kingdom.

OBJECTIVE: Hypothyroidism is more frequently diagnosed in women and older individuals. It has been suggested that the prevalence of hypothyroidism and the number of prescriptions for thyroid hormones are increasing. However, despite hypothyroidism being a common medical condition, contemporary data on prevalence, particularly across the various age groups, is limited. DESIGN: Information regarding number of individuals diagnosed with treated hypothyroidism (defined as patients prescribed levothyroxine) across ten General Practices (total population of 66 843) in the North-East of England in 2016 was obtained in an anonymized manner. Total as well as age group-specific point prevalence rates were calculated. In addition, corresponding population data for the United Kingdom were acquired, and national total and age-specific hypothyroidism prevalence rates were estimated. RESULTS: The overall prevalence of hypothyroidism in this community sample was 4.5% (n = 3004). Prevalence increased across the age groups from 0.1% in children aged 0-10 years to 15.1% in those aged more than 90 years. After adjusting for demographic differences between the North-East England and UK populations, it is estimated that the total UK-wide prevalence of hypothyroidism in 2016 is 3.6%; affecting more than 2.3 million individuals including nearly 800 000 individuals aged >70 years. CONCLUSIONS: Hypothyroidism affects millions of individuals in the UK and is currently a prevalent diagnosis in more than 1 in 10 individuals aged above 70 years. As the population ages this number is likely to increase. The clinical and economic effects of current management strategies for hypothyroidism, particularly in the older population, need to be evaluated.

GP contact with patients after treatment for hip fracture: frequency and determinants.

BACKGROUND: Patients with hip fracture have complex medical issues, both at the time of admission and after discharge from hospital. We have observed a surge in patient-initiated and carer-initiated contacts with general physicians (GPs) for periods longer than those usually reported, in a series of patients sustaining fractures from July 2008 to September 2013. OBJECTIVES: To establish (1) the frequency of contact with GPs (primary outcome) and (2) the factors influencing the frequency of different modes of contact. METHODS: Ten GP practices in West Northumberland were asked to retrospectively identify patients sustaining hip fractures, and to provide data on the number of GP contacts (patient visits to GP, telephone consultations, GP visits to patient's home) up to 1 year before and 1 year after fracture. Generalised linear models (GLM) were constructed using number of postfracture GP contacts as response variable; age, gender, residential status, number of prefracture contacts and days to contact postfracture were covariates. RESULTS: Each patient recorded cumulative 8.4 GP contacts before and 10.79 contacts after fracture. There were significantly more telephone contacts with GPs and GP home visits, but significantly fewer patient visits to GP clinics. In the GLM analysis, patient age and number of prefracture GP contacts predicted all types of postfracture contacts, while gender was not. Patients discharged home visited their GPs five times more frequently than those discharged to institutional care. CONCLUSIONS: After hip fractures, telephone contacts and GP visits to patients' homes increase, but patient visits to GP clinics decrease, influenced by age and residential status.