Koh J S, Cho K J, Kim H S, Kim J C
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Int J Clin Pract. 2014 Feb;68(2):197-202. doi: 10.1111/ijcp.12241. Epub 2013 Dec 22.
This study aimed to assess patients' baseline characteristics and provider factors influencing the continuation of medication for 12 months in patients who were newly diagnosed with benign prostatic hyperplasia (BPH).
This study was conducted in patients with newly diagnosed lower urinary tract symptoms (LUTS)/BPH (age ≥ 40) who received either one or a combination of the two pharmacological classes of drugs (alpha-blockers or 5-alpha-reductase inhibitors) from January 2008 to January 2010. Patient demographics and clinical data were assessed from the electronic patient records and telephone surveys. Persistence was defined as continuation of all BPH medications prescribed at the start of the first treatment. Logistic regression analysis was used to evaluate the association between 12-month persistence and patient or provider factors.
Of the 789 newly diagnosed LUTS/BPH patients, 670 (84.9%) were included in the study. Twelve-month persistence for LUTS/BPH medication was 36.6%. Independent predictors of 12-month medication persistence included larger prostate volume, higher prostate specific antigen, having an adequate income and a good patient-doctor relationship. Important reasons for discontinuation were resolved symptoms (31.1%), no improvement in symptoms (23.7%) and adverse events (20.0%).
About two-thirds of newly diagnosed LUTS/BPH patients discontinued medications within 1 year of starting treatment. We found several potential patient and provider factors associated with persistence, which could be exploited to increase continuation of treatment in future clinical settings.
本研究旨在评估新诊断为良性前列腺增生（BPH）患者的基线特征以及影响其持续用药12个月的医疗服务提供者因素。
本研究纳入了2008年1月至2010年1月期间新诊断为下尿路症状（LUTS）/BPH（年龄≥40岁）且接受α受体阻滞剂或5α还原酶抑制剂这两类药物中的一种或联合用药的患者。通过电子病历和电话调查评估患者的人口统计学和临床数据。持续性被定义为在首次治疗开始时所开具的所有BPH药物的持续使用。采用逻辑回归分析来评估12个月持续性与患者或医疗服务提供者因素之间的关联。
在789例新诊断的LUTS/BPH患者中，670例（84.9%）纳入研究。LUTS/BPH药物的12个月持续性为36.6%。12个月药物持续性的独立预测因素包括前列腺体积较大、前列腺特异性抗原水平较高、有足够的收入以及良好的医患关系。停药的重要原因是症状缓解（31.1%）、症状无改善（23.7%）和不良事件（20.0%）。
约三分之二新诊断的LUTS/BPH患者在开始治疗的1年内停药。我们发现了几个与持续性相关的潜在患者和医疗服务提供者因素，未来在临床环境中可利用这些因素来提高治疗的持续性。
