S. R. Brown1, N. Bhutiani1, A. R. Quillo1 1University Of Louisville,Department Of Surgery, Division Of Surgical Oncology,Louisville, KY, USA
Introduction: Patients undergoing parathyroidectomy for primary hyperparathyroidism require long-term follow-up to adequately assess for cure of their disease. For many of these patients, committing to repeated follow-up appointments, particularly 6 or 12 months after surgery, proves difficult. The objectives of this study are to identify barriers to follow-up in patients undergoing parathyroidectomy for primary hyperparathyroidism, identify strategies to increase likelihood of follow-up, and sample patient interest in alternatives to traditional clinic visits.
Methods: 98 patients undergoing parathyroidectomy between December 2012 and June 2015 who had both mailing address and working telephone number were identified. These patients were sent a survey via mail regarding factors potentially influencing their ability to keep follow-up appointments and their attitudes towards alternative means of follow-up. Survey results were tabulated and analyzed to identify factors affecting follow-up and potential alternatives.
Results: A total of 21 patients (21%) responded to the survey. Patients lived an average of 22.6 miles from the surgery clinic offices in downtown Louisville (range 1 to 80 miles). 12 patients (57%) attended scheduled follow-up visits. Of those patients that did not attend these visits, the majority (67%) cited being unaware of or forgetting their appointment as the reason for their absence. Most patients stated that they still prefer a face-to-face visit with their surgeon for follow-up, though patients living greater than 35 miles from downtown Louisville and those with disabilities noted a preference for a telephone or videoconference based follow-up.
Conclusion: A number of patient-specific factors represent barriers to long-term surgical follow-up in patients undergoing parathyroidectomy for benign disease, including patient awareness, distance to tertiary referral center, and logistic considerations. For patients with such considerations, maintaining close communication with patients’ endocrinologists and primary care providers represents a potentially effective strategy to ensure long-term cure of their hyperparathyroidism.