Ümmü MUTLU, Ayşe Merve OK KURT
The Turkish Journal of Ear Nose and Throat - 2025;35(4):185-193
Objectives: Hypoparathyroidism, most commonly occurs following thyroid surgery, and presents with hypocalcemia and low/low-normal parathyroid hormone levels. Biochemical control is often inadequate with conventional treatment and mainly depends on the patient's compliance. This study was conducted to evaluate medication adherence in patients with chronic hypoparathyroidism using the Medication Adherence Report Scale (MARS-5) and to assess its relationship with biochemical control and clinical outcomes. Material and Method: This cross-sectional study was conducted between June and December 2023. Forty-one adult patients with chronic hypoparathyroidism were included. Medication adherence was assessed using the MARS-5 and EQ-5D-5L quality of life questionnaires. The relationship between medication adherence and clinical findings and outcomes was examined. Results: The mean age was 44+/-10.6 years, and 87.8% of patients were female. The most common etiology was postoperative hypoparathyroidism (92.7%). Only 29.3% had target calcium levels. Within the last two years, 56.1% had visited the emergency department, and 24.4% had been hospitalised. Median MARS-5 scores were 16 (12-21) for calcium and 23 (15-25) for active vitamin D. Adherence to calcium therapy was markedly low. Target calcium levels were achieved more frequently in calcium adherent patients (71.4% vs. 20.5%, p=0.016). Main reasons for non-adherence were forgetfulness (80.5%), reluctance (31.7%), and lack of understanding of the importance of treatment (24.4%). Conclusion: Medication adherence in chronic hypoparathyroidism, particularly for calcium therapy, is quite low and is closely associated with inadequate biochemical control. Improving adherence through patient education, simplified treatment regimens, and regular follow-up is essential for optimal disease management.
