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TFT Monitoring in patients taking Amiodarone

TFT Monitoring in patients taking Amiodarone. Dr Naznaz Mohammed. ST2 General Practice. Aims: Quantify adherence to published guidelines / recommendations for serial monitoring of chronic amiodarone therapy > 6 month.

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TFT Monitoring in patients taking Amiodarone

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  1. TFT Monitoring in patients taking Amiodarone Dr Naznaz Mohammed ST2 General Practice

  2. Aims: • Quantify adherence to published guidelines / recommendations for serial monitoring of chronic amiodarone therapy > 6 month. • The UK Guideline for the use of TFT regarded as a measure of appropriate monitoring.

  3. Criteria: • All patients should have their TFT monitored every 6 months after starting amiodarone this include TSH, T4 and T3 . Standard: • 90% of patients should have had their TFT measured and recorded in the last 6 months.

  4. Method: • Practice staff helped to pull out a list of patients on chronic amiodarone therapy. • 20 patients were taking amiodarone • Ages range between 61-87 years • Duration of therapy 8 months -15 years

  5. Results/ Data: • 10 out of 20 have has their TSH measured and recorded in the previous 6 months • All of the patients who have had their TFT yearly, only one of those has had his TSH measured every 6 months.

  6. Conclusion: • 50% of patients have their TSH measured compared to standard which is 90% • The patients taking amiodarone longest have had the smallest % of recorded TFT every 6 months. • The monitoring of TFT in patients on Amiodarone is less than ideal.

  7. Recommendations • To improve outcomes involve: • Doctors : Guidelines awareness ( algorithms for managing abnormal TFT) • Patients: Amiodarone and TFT leaflets / handouts Letters explaining follow-ups Choices where to take test • Staff: Educate and involve in monitoring Designate a member to check TFT twice yearly. • IT : Identify those not taking tests and generate notices. Include new patients and make sure they have similar monitoring. • Re Audit in 6 months

  8. References • Monitoring the use of amiodarone : compliance with guidelines Internal Medical Journal , vol.36 Issue 5 • UK guidelines for the use of TFT British Thyroid Association British Thyroid Foundation The association for clinical biochemistry 1st July 2006 • Amiodarone –Induced Thyrotoxicosis Medscape Today

  9. Any Questions ?

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