Open AccessReal‐world therapeutic management and evolution of patients with benign prostatic hyperplasia in primary care and urology in Spain
Author(s) -
Miñana Bernardino,
Molero José María,
Agra Rolán Alfonso,
MartínezFornes Miguel Téllez,
Cuervo Pinto Rafael,
Lorite Mingot David,
Carreño Ágata,
PalaciosMoreno Juan Manuel
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.14250
Subject(s) - medicine , lower urinary tract symptoms , benign prostatic hyperplasia (bph) , urology , hyperplasia , tamsulosin , primary care , retrospective cohort study , gynecology , prostate , family medicine , cancer
Objectives This study aimed to describe the real‐world therapeutic management of patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) (LUTS/BPH) attending primary care and urology clinics in Spain. Methods This observational, retrospective, multicentre study included men ≥50 years of age diagnosed with LUTS/BPH (≤8 years prior to study visit) (N = 670). Therapeutic management according to healthcare service (primary care vs. urology clinics) or progression criteria, proportion of patients with treatment change, patient profile according to therapy and evolution of LUTS severity were assessed. Results Overall differences were noticed in the management of patients between healthcare service ( P < .001) and with or without progression criteria ( P < .05). Most patients received pharmacological treatment at diagnosis (70.7%; 474/670), which increased at study visit (81.6%; 547/670) with overall similar profiles between primary care and urology clinics for each therapy. α1‐Blockers were the most used pharmacological treatment across healthcare settings at diagnosis (61.8%; 293/474) and study visit (51%; 279/547). Only 27.1% (57/210) of patients with progression criteria at diagnosis and 35.6% (99/278) at study visit received 5α‐reductase inhibitor (5ARI) alone or in combination with a α1‐blocker. Overall, most patients did not change treatment (60%; 402/670) with a trend of more patients worsening in symptoms when not receiving α1‐blocker plus 5ARI combination therapy. Conclusion Most patients with LUTS/BPH received pharmacological treatment; however, most men with progression criteria did not receive a 5ARI alone or in combination. These results support the need to reinforce both primary care and urologists existing clinical guideline recommendations for the appropriate medical management of patients with LUTS/BPH.