Abstract
Background: Many children with hypothyroidism struggle to take their levothyroxine as prescribed, and no clear answer exists on whether giving the dose in the morning or evening changes its effectiveness.
Objective: This study aimed to evaluate whether a pharmacist-led educational intervention optimizes medication adherence, parental knowledge, quality of life, and normalizes thyroid function, while comparing morning versus evening levothyroxine dosing.
Method: This prospective interventional study included 73 children with hypothyroidism (48 receiving levothyroxine in the morning, 25 in the evening) who completed baseline and post-intervention assessments. Adherence was measured using the Medication Adherence Report Scale (MARS-5), parental knowledge using a validated six-item questionnaire, and quality of life using the Pediatric Quality of Life Inventory (PedsQL 4.0). A clinical pharmacist delivered a structured educational session, and serum thyroid-stimulating hormone (TSH) together with total thyroxine (T4) were measured both beforehand and again afterward.
Results: After the intervention, medication adherence improved substantially, with the median MARS score climbing from 68.0% to 92.0% of the maximum attainable value (p<0.001). Parental knowledge followed a similar trend, rising from a median of 77.8% to 88.9% (p<0.001), while quality of life nearly doubled, as the total PedsQL score moved from 30.43 to 53.26 on a 0-100 scale (p<0.001). Serum TSH fell from a median of 19.85 to 7.00 mIU/L (p<0.001), whereas total T4 changed little. Gains in adherence and TSH were comparable across both administration groups.
Conclusion: A pharmacist-led educational intervention significantly enhanced medication adherence, parental knowledge, quality of life, and laboratory thyroid parameters in children with hypothyroidism. These benefits were seen whether the medication was taken in the morning or the evening, suggesting dosing time was not the deciding factor.
| Has the manuscript been published | not published |
|---|---|
| Intend to be published in the IJPS ? | NO |
