Results of a novel intervention to increase rates of diagnosis and treatment of primary hyperparathyroidism

Am J Surg. 2024 Apr 27:S0002-9610(24)00266-6. doi: 10.1016/j.amjsurg.2024.04.029. Online ahead of print.

Abstract

Background: Veterans with primary hyperparathyroidism are under diagnosed and undertreated. We report the results of a pilot study to address this problem.

Methods: We implemented a stakeholder-driven, multi-component intervention to increase rates of diagnosis and treatment for primary hyperparathyroidism at a single VA hospital. Intervention effects were evaluated using an interrupted time series analysis.

Results: The mean age of Veterans affected by the intervention was 67 years (SD 12.1) and 84 ​% were men. Compared to the pre-intervention period, the intervention doubled the proportion of Veterans who were appropriately evaluated for hyperparathyroidism (absolute difference 25 ​%, 95 ​% CI 11 ​%-38 ​%, p ​< ​0.001) and increased referrals for treatment by 27 ​% (95 ​% CI 7 ​%-47 ​%, p ​< ​0.012).

Conclusion: Our pilot study suggests it is feasible to address the underdiagnosis and undertreatment of primary hyperparathyroidism among Veterans.

Keywords: Diagnosis; Hypercalcemia; Primary hyperparathyroidism; Referral; Veteran.