Cardiac Output, Venous Return, and Their Regulation
Thyrogen final market research by parthi ppt
1. HYPOTHYROIDISM DURING
DISCONTINUATION OF THYROID HORMONE
BEFORE CONDUCTING RADIOIODINE
THERAPY OR SCANS IN PATIENTS OF
THYROID CANCER
BY:
PARTHI SINGHA
MBA (Pharmaceuticals Mgmt.)
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NMIMS, Mumbai Page 1
2. BACKGROUND OF THE
STUDY
•Patients discontinue thyroid hormone medicine
for 4-6 weeks before radioiodine therapy or whole
body scan
•Patients experience short-term hypothyroidism
•The quality of life of the patient gets affected
during this time
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3. STUDY PURPOSE
•To investigate the effect of discontinuation of
thyroid hormone for thyroid cancer treatment and
follow up test on the patient’s quality of life
•To analyze whether there exists a perception
gap between the doctors and the patients on the
extent of symptoms experienced by the patients
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4. PRIMARY POINT OF
RESEARCH
There exists a perception gap between the
doctors and the patients on the severity
of symptoms during the time of hypothyroidism.
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5. STUDY DESIGN
USE OF TWO TYPES OF
QUESTIONNAIRES:
• For doctors who treat thyroid cancer
Specialties covered:
Surgical Oncologists, Endocrinologists and
Nuclear Medicine
• For patients who discontinued thyroid hormone
for Thyroid cancer treatment and follow up test
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6. METHOD OF ANALYSIS
• Frequency Analysis
• Comparative Analysis
• Duration of study: For one month
June, 2011
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7. MULTICENTRE SURVEY
ON HYPOTHYROIDISM
• CITIES COVERED:
Delhi, Bangalore, Hyderabad, Mumbai
• Number of Hospitals interviewed: 33
• Number of Doctors interviewed: 73
• Number of Patients interviewed: 55
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21. ANALYSIS OF DOCTOR
QUESTIONNAIRE
Q) For how long do you discontinue thyroid hormone
for conducting radioiodine therapy or scan?
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23. ANALYSIS OF DOCTOR
QUESTIONNAIRE
Q) What experience do you think hypothyroidism
would be in a patient’s life?
60%
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24. ANALYSIS OF DOCTOR
QUESTIONNAIRE
Q) Please choose all the symptoms which the
patients complain about?
Top 5 symptoms chosen by the Doctors:
Fatigue/Lethargy
Body swelling
Weight gain
Joint pain
Constipation
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29. ANALYSIS OF DOCTOR
QUESTIONNAIRE
• CONSTIPATION
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30. ANALYSIS OF DOCTOR
QUESTIONNAIRE
Other symptoms which the patients complain
about:
Hairfall/Hairloss
Skin dryness
Breathlessness
Increased sleepiness
Irregular menses
Pimples
Cold intolerance
Back ache
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31. INSIGHTS FROM DOCTORS
Ability to handle
Tell patients that some
hypothyroidism depends
problems will happen
on the psychology of the
because of discontinuation
patient and is
and they should not panic.
individualistic.
Most of the patients prefer
Recombinant TSH is to be a hypothyroid for a
available in the market month even if they can
but it is very expensive. afford it.
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32. INSIGHTS FROM DOCTORS
I use T3 replacement in Take into account cost factor
my patients which is and economic condition of
cheaper than Thyrogen. the patient before
recommending Thyrogen.
Thyrogen can be Recommend Thyrogen
recommended to most patients to selected patients with
if the cost is manageable. co morbid conditions.
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34. PATIENT DEMOGRAPHICS
A Total of 55 Patients Total Female Male
(42 patients,74%) (13 patients, 26%)
No. of radioiodine Once 22(40%) 16(38%) 6(47%)
Therapies/test Twice 17(30%) 11(26%) 5(38%)
Thrice 5(10%) 4(10%) 2(15%)
>=Four 11(20%) 11(26%)
>
Discontinuation <=4 weeks 4(7%) 3(7%)
period of thyroid =4 weeks 47(86%) 35(83%) 11(85%)
Hormone >=4 weeks 4(7%) 4(10%) 2(15%)
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35. ANALYSIS OF PATIENT
QUESTIONNAIRE
Q) Please choose all the symptoms you experience
during discontinuation of thyroid hormone
Top 5 symptoms chosen by patients:
Fatigue/Lethargy
Weight gain
Body swelling
Joint/Muscle pain
Depression
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41. ANALYSIS OF PATIENT
QUESTIONNAIRE
Other symptoms experienced by patients:
Breathlessness
Back ache
Increased sleepiness
Cold intolerance
Change in sleeping pattern
Hairfall/Hairloss
Hoarseness of voice
Vertigo
Irregular menses
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42. ANALYSIS OF PATIENT
QUESTIONNAIRE
Did you tell your doctor about the symptoms?
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43. ANALYSIS OF PATIENT
QUESTIONNAIRE
Areas of daily life in which you faced difficulties
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44. EXPERIENCE WITH
HYPOTHYROIDISM
Having negative feelings Faced emotional
all the time. I was disturbances as I live in
loosing interest in life. a joint family.
Getting irritated and Completely lost my
taking frustration out appetite and not able
on my children. to have my meals.
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45. EXPERIENCE WITH
HYPOTHYROIDISM
My body feels bloated
up and I feel a lot of Experience a lot of anxiety
heaviness all the time. and feel uncertain
Had to live in a different
city for a long time and My voice has changed.
was detached from my
family.
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46. INSIGHTS FROM A
THYROGEN USER
Because of Thyrogen, Thyrogen will help me
my scan can be conducted know in a shorter time
faster. I wont have to wait if my cancer has
for 1 month. spread.
I don’t have to wait.
I can start my treatment
soon as cancerous cells
spread very fast.
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53. KEY PERCEPTION GAP
FINDINGS
Perception Gap existing in following areas:
• Explanation and management of the symptoms
• Impact of hypothyroidism on the emotional life of
the patient
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55. RECOMMENDATIONS
FOR DOCTORS
Hospital wise strategy
Specifying clinical conditions and co morbid
conditions
Justify cost vs. benefit analysis
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56. RECOMMENDATIONS
FOR PATIENTS
Patient information booklets for effective
management and follow up treatment
Gap in information on reimbursement by
Insurance companies
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