Abstract
<jats:p>An important problem in medicine and healthcare is thyroid disease. Among endocrine system diseases, they rank second in prevalence after diabetes mellitus and pose a significant burden on society and healthcare systems, as they usually affect women of working age, require long-term treatment, lead to disability (temporary and permanent) and premature mortality. Primary healthcare teams (doctors and nurses) play an important role in the prevention of chronic diseases, including thyroid disorders. This could be of great importance for Ukraine, where the availability of specialized medical services for the population has significantly decreased as a result of the full-scale war with the russian federation. In order to identify directions for improving the prevention of thyroid cancer and other chronic thyroid diseases at the primary health care level in the context of full-scale war, a retrospective case-control study was conducted during 2024-2025. The main groups consisted of patients from the capital's specialized endocrinology center with cancer (95) and other chronic thyroid diseases (505), and the comparison group consisted of practically healthy individuals (172). The comparison groups did not differ in age, gender, or place of residence (p>0.05). The survey was conducted using a specially developed author's program, which contained questions about demographic characteristics, potential risk factors, accessibility, use, and satisfaction with health care services. It has been established that with the emergence of chronic thyroid disease, the compliance with drug treatment increases (OR=8.86; 95 % CI: 1.15-68.22 for thyroid cancer and OR=1.84; 95 % CI: 1.25-2.71 for other chronic thyroid diseases). A similar increase was observed in terms of lifestyle corrections (OR=4.92; 95 % CI: 2.75-8.83 and OR=1.83; 95 % CI: 1.26-2.67, respectively) and dietary changes (OR=3.68; 95 % CI: 2.10-6.43 and OR=1.73; 95 % CI: 1.19-2.52). This also correlates directly (rs=0.77-0.94) with an increase in the chances of higher satisfaction with medical care (OR=4.10; 95 % CI: 2.38-7.06 and OR=2.86; 95 % CI: 1.98-4.13). Significant reserves have been identified for involving primary care teams in the prevention of thyroid cancer and other chronic thyroid diseases, particularly in terms of early detection (47.1-49.6 %), coverage of patients with long-term follow-up (33.3-42.2 %), monitoring compliance with medical recommendations regarding the regularity of follow-up visits (18.4-28.9 %), medication intake (23.4 %), lifestyle changes (23.5-49.2 %), and nutritional habits (33.3-51.5 %). The barriers to the growing role of primary care teams in the prevention of chronic thyroid diseases have been identified. They were associated with a high level of distrust of this type of medical care (54.5-58.9 %) due to outdated equipment (17.7-33.3 %), lack of coordination with other health care units (18.5-33.3 %), and high cost of medicines (20.1-25.0 %). It was concluded that there is a need to develop a set of measures aimed at broader involvement of primary care teams in the prevention of chronic thyroid diseases, which is highly promising, particularly in the context of reduced access to specialized medical care due to the full-scale war with the russian federation.</jats:p>