Medication Adherence Among Patients with Hypothyroidism Receiving Levothyroxine: A Review

Hypothyroidism is a prevalent endocrine disorder resulting from insufficient production of thyroid hormones, particularly thyroxine (T4) and triiodothyronine (T3), which play critical roles in metabolic regulation and overall physiological function. Levothyroxine (LT4), a synthetic T4 replacement, is the standard treatment to restore euthyroidism. Despite its efficacy, achieving optimal therapeutic outcomes heavily depends on consistent patient adherence to prescribed therapy. Non-adherence remains a widespread challenge, influenced by various factors such as forgetfulness, lack of awareness, complex dosing regimens, cost, and coexisting conditions. Barriers to adherence include both unintentional factors like cognitive decline or misunderstanding instructions, and intentional ones such as perceived lack of efficacy or concerns about side effects. Inadequate adherence can lead to persistent symptoms, altered biochemical parameters, and increased risk of complications. Identifying and addressing these barriers is crucial in managing hypothyroid patients effectively. Methods to evaluate adherence include patient self-reports, pill counts, pharmacy refill records, and validated adherence scales. Strategies to improve adherence range from patient education and medication reminders to simplifying regimens and enhancing doctor–patient communication. This review emphasizes the importance of early diagnosis, regular monitoring, and a patient-centred approach to therapy. Tailoring interventions to individual patient needs can improve adherence, optimize treatment outcomes, and enhance quality of life for individuals with hypothyroidism.