Evaluation of Knowledge, Practices and Adherence to Levothyroxine Therapy in Patients with Hypothyroidism Attending a Family Medicine Outpatient Clinic: A Cross-Sectional Study

Aim: To evaluate levothyroxine-related knowledge, medication-use practices, and adherence among adults with hypothyroidism attending a primary care outpatient clinic. Methods: This cross-sectional descriptive study included 213 hypothyroid patients using levothyroxine who attended the Pamukkale University Faculty of Medicine Family Medicine Outpatient Clinic between 1 August and 30 November 2024. Adherence was assessed using the 6-item Modified Morisky Scale. Participation was voluntary, and completion of the anonymous questionnaire implied consent. Data were analyzed using IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY, USA), used under a valid license. Results: The mean age was 41.1±14.6 years and 86.9% were female. Most participants reported taking levothyroxine in the morning (99.5%) and on an empty stomach (98.6%); however, only 30.5% knew it should be separated from interacting drugs or supplements by ≥4 hours. High motivation and high knowledge domain score were observed in 65.7% and 87.3%, respectively. Knowledge scores were higher in younger and more educated participants and lower in those with comorbidities. Conclusion: Although overall levothyroxine intake timing was appropriate, important knowledge gaps remain regarding drug–drug/drug–supplement interactions. Targeted education and reinforcement at follow-up may improve adherence and treatment outcomes. Keywords: hypothyroidism, thyroxine, medication adherence, knowledge, health behavior, family practice