Logie J W, Clifford G M, Farmer R D, Meesen B P
Department of Pharmacoepidemiology and Public Health, Postgraduate Medical School, University of Surrey, Stirling Road, Surrey Research Park, Guildford GU2 7DJ, UK.
Eur Urol. 2001;39 Suppl 3:42-7. doi: 10.1159/000052567.
The Triumph project aims to document the current management of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) in general practice and to assess the effectiveness of the initial treatment options used. The first phase of the project will consider existing data sources in primary care. A patient's medical record will contain most, if not all, clinically relevant information, and databases combining the records from a network of computerised general practices can provide longitudinal data for complete populations, linking prescribing records to clinical information on disease progression and outcomes for individual patients. Database research can provide rapid information and offers the ability to conduct studies on a scale that would previously have been prohibited by both time and expense. Within the Triumph project, the THALES, General Practice Research Database (GPRD) and Integrated Primary Care Information (IPCI) databases are, or will be, used to examine the current management of LUTS/BPH in France, the UK and the Netherlands respectively. Preliminary results from the UK General Practice Research Database (GPRD) showed that LUTS/BPH incidence increased linearly from the ages of 45 to 85 years (r(2) = 0.992) and prevalence increased from 3.5% to 35% for men in their late 40s and 80s respectively. With treatment failure defined as a change to another medical therapy, catheterisation or prostatic surgery, and accounting for age and year variation, patients receiving the older alpha(1)-blockers (indoramin and prazosin) appeared to fail significantly earlier than those receiving finasteride. There was no significant difference between finasteride and the newer alpha(1)-blockers (tamsulosin, alfuzosin, terazosin and doxazosin). Patterns of changes between products from the THALES database in France were broadly similar to those seen in the UK.
“凯旋”项目旨在记录全科医疗中对提示良性前列腺增生（BPH）的下尿路症状（LUTS）的当前管理情况，并评估所采用的初始治疗方案的有效性。该项目的第一阶段将考虑初级保健中的现有数据源。患者的病历将包含大部分（如果不是全部）临床相关信息，并且结合来自计算机化全科医疗网络记录的数据库可以为整个人群提供纵向数据，将处方记录与个体患者疾病进展和结局的临床信息相联系。数据库研究可以提供快速信息，并能够进行以前因时间和费用限制而无法开展的大规模研究。在“凯旋”项目中，THALES数据库、全科医疗研究数据库（GPRD）和综合初级保健信息（IPCI）数据库分别用于（或将要用于）研究法国、英国和荷兰对LUTS/BPH的当前管理情况。英国全科医疗研究数据库（GPRD）的初步结果显示，LUTS/BPH的发病率在45至85岁之间呈线性增加（r² = 0.992），40多岁后期和80多岁男性的患病率分别从3.5%升至35%。将治疗失败定义为改用另一种药物治疗、导尿或前列腺手术，并考虑年龄和年份差异，接受较老的α1受体阻滞剂（吲哚拉明和哌唑嗪）治疗的患者似乎比接受非那雄胺治疗的患者更早出现治疗失败。非那雄胺与较新的α1受体阻滞剂（坦索罗辛、阿夫唑嗪、特拉唑嗪和多沙唑嗪）之间没有显著差异。法国THALES数据库中不同产品之间的变化模式与英国所见大致相似。
