Oelke Matthias, Anderson Peter, Wood Robert, Holm-Larsen Tove
Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany.
Adelphi Real World, Bollington, UK.
Int J Clin Pract. 2016 Nov;70(11):940-949. doi: 10.1111/ijcp.12882. Epub 2016 Oct 17.
The aim of this study was to investigate the quality and timing of the diagnosis and treatment of nocturia in real-life practice in European and US-American patients to obtain better insights into the management of nocturia in different Western healthcare systems.
Data were drawn from the "LUTS Disease Specific Programme," a real-life survey of physicians and patients in France, Germany, Spain, UK and the USA. Physicians completed a patient record form for lower urinary tract symptoms (LUTS) patients. Patients filled out a self-completion form, indicating - among other items - information on the mean number of day- and night-time voids during the last 7 days, and questions on the management of LUTS in daily practice.
In total, 8659 patients were analysed. The majority of patients initially consulted a physician because of worsening of LUTS frequency (43%-58%) or severity (44%-55%). Only 37% of all LUTS diagnoses, regardless of the appearance or severity of nocturia, were based on bladder diaries. Patients took approximately 1 year to consult a medical professional following the onset of LUTS. At the initial visit, most patients received advice on behavioural strategies. Regardless the type of LUTS and physician, 59% of men received α-blockers and 76% of women antimuscarinics.
Data show that patients with nocturia and LUTS accept their symptoms for a considerable period before they seek help or ultimately receive treatment. They may therefore be enduring significant negative impact on their quality-of-life which could be avoided. Physicians rarely use bladder diaries and primarily use antimuscarinics (women) or α-blockers (men). Improved awareness of nocturia among patients and physicians could improve the management of nocturia.
本研究旨在调查欧美患者在现实生活中夜尿症的诊断和治疗质量及时机，以便更好地了解不同西方医疗体系中夜尿症的管理情况。
数据来自“下尿路症状疾病特定项目”，这是一项对法国、德国、西班牙、英国和美国的医生及患者进行的现实生活调查。医生为下尿路症状（LUTS）患者填写一份病历表。患者填写一份自填式表格，除其他项目外，表明过去7天白天和夜间排尿的平均次数信息，以及关于日常实践中LUTS管理的问题。
总共分析了8659名患者。大多数患者最初因LUTS频率恶化（43%-58%）或严重程度恶化（44%-55%）而咨询医生。无论夜尿症的表现或严重程度如何，所有LUTS诊断中只有37%基于膀胱日记。LUTS发作后，患者大约需要1年时间才咨询医疗专业人员。在初次就诊时，大多数患者接受了行为策略方面的建议。无论LUTS类型和医生如何，59%的男性接受了α受体阻滞剂治疗，76%的女性接受了抗毒蕈碱药物治疗。
数据表明，夜尿症和LUTS患者在寻求帮助或最终接受治疗之前，会在相当长一段时间内忍受症状。因此，他们的生活质量可能受到重大负面影响，而这种影响本可避免。医生很少使用膀胱日记，主要使用抗毒蕈碱药物（女性）或α受体阻滞剂（男性）。提高患者和医生对夜尿症的认识可能会改善夜尿症的管理。
