A Systematic Review of Patient Preferences, Expectations, and Values for the Management and Treatment of Graves Disease.

Abstract

<h4>Objective</h4>To systematically synthesize evidence on treatment preferences, values, and expectations among patients with Graves' disease (GD), in order to understand the disease's impact on quality of life and inform clinical decision-making..<h4>Methods</h4>PubMed, Embase, Web of Science, and Cochrane Library were searched for articles about GD, patient preferences, and expectations from database inception to December 2024. Studies included in the review must report raw data on patient-reported outcomes, preferences or experiences relating to GD, and must undergo quality assessment according to the Agency for Healthcare Research and Quality (AHRQ).<h4>Results</h4>Twenty-one studies involving patients with GD were included. Although preferences varied, several trends emerged: 1) Most patients reported that GD significantly disrupted their quality of life and social functioning, with 60% experiencing severe discomfort. 2) Antithyroid drugs (ATD) was the most preferred initial treatment (64%), followed by surgery (25%) and radioactive iodine therapy (RAI) (11%), with concerns about radioactivity and surgical complications influencing decisions. 3) Key factors affecting treatment choices included remission rates, recovery time, impact on daily life, and physician recommendations. 4) Graves' ophthalmopathy (GO) patients faced additional challenges, including social withdrawal and appearance-related distress, with female patients expressing greater concern about disfigurement.<h4>Conclusion</h4>This systematic review indicates that GD, particularly GO, significantly impairs patients' self-confidence, quality of life, and social functioning. Treatment choices are influenced by expected outcomes, personal circumstances, psychological concerns, and economic factors. ATD remains the preferred first-line treatment, though individual preferences vary significantly, emphasizing the importance of personalized approaches and decision aids.