Hutchison Annie, Farmer Richard, Chapple Christopher, Berges Richard, Pientka Ludger, Teillac Pierre, Borkowski Andrzej, Dobronski Piotr
Postgraduate Medical School, University of Surrey, Guildford, United Kingdom.
Eur Urol. 2006 Sep;50(3):555-61; discussion 562. doi: 10.1016/j.eururo.2006.05.001. Epub 2006 May 19.
Knowledge of the clinical profile of the population with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) is important for health care management, impacting on manpower requirements, pharmacologic demands and health service costs. Data collected by the TransEuropean Research Into the Use of Management Policies for LUTS suggestive of BPH in Primary Health care project were used to profile 4979 patients from six European countries newly presenting with LUTS/BPH to general practitioners or office-based urologists.
At recruitment, the clinician completed a questionnaire detailing the treatment provided, examination results, and covariates including age, initial symptom severity and comorbidities. The patient completed an International Prostate Symptom Score/quality-of-life questionnaire.
The majority of patients (77%) sought medical advice because of the bothersomeness of their symptoms, and presented at ages between 58 and 71 years. Small but statistically significant differences among countries were found in initial symptom severity, initial quality of life and age at diagnosis, but these are not thought to be clinically significant. There were marked national differences in patient management, with, for example, 10% of patients in France reporting no examinations, compared with 0.5% in Poland, while free-flow measurements varied from less than 1% in France to 35% in Poland.
Patient heterogeneity does not explain the differences in patient management among countries, which undoubtedly is the result of differences in health care traditions, infrastructure and socioeconomic factors, as well as patient preference.
了解下尿路症状/良性前列腺增生(LUTS/BPH)患者的临床特征对于医疗管理至关重要,会影响人力需求、药物需求和医疗服务成本。泛欧洲初级卫生保健中LUTS提示BPH管理政策应用研究项目收集的数据,用于对六个欧洲国家新出现LUTS/BPH症状并向全科医生或门诊泌尿科医生就诊的4979例患者进行分析。
招募时,临床医生填写一份问卷,详细列出所提供的治疗、检查结果以及包括年龄、初始症状严重程度和合并症在内的协变量。患者完成一份国际前列腺症状评分/生活质量问卷。
大多数患者(77%)因症状困扰寻求医疗建议,就诊年龄在58至71岁之间。在初始症状严重程度、初始生活质量和诊断年龄方面,各国之间存在微小但具有统计学意义的差异,但这些差异被认为不具有临床意义。患者管理方面存在明显的国家差异,例如,法国10%的患者报告未进行检查,而波兰这一比例为0.5%,自由尿流率测量在法国不到1%,在波兰则为35%。
患者异质性并不能解释各国在患者管理上的差异,这种差异无疑是医疗传统、基础设施、社会经济因素以及患者偏好不同的结果。