Dataset Information

Prescription pattern of alpha-blockers for management of lower urinary tract symptoms/benign prostatic hyperplasia.

ABSTRACT: This study investigated trends in the prescription of ?-blockers for patients with BPH, focusing on changing patterns of prescriptions during 2002-2013 using National Health Insurance Service-National Sample Cohort data. A total of 65,596 Korean males over 50 years old diagnosed with BPH were identified from the NHIS-NSC database between 2002-2013. Patterns of each ? -blocker prescription were analyzed and persistence rate, switch rate, and return rate during a follow-up period of 3 years after the first prescription were calculated. A total of 28,318 men over 50 years old (64.95?±?9.12), changed medication within six months following the first prescription of ? -blocker. (1) Tamsulosin showed the highest persistence rate when compared with other ?-blockers (2) Among patients who switched to a second ?-blocker, tamsulosin showed the highest return rate when compared with other ?-blockers. Tamsulosin has been the most commonly prescribed ?1-blocker since the mid-2000s, in line with its demonstrated highest persistence and return rates. These data probably reflect patient satisfaction with ?1-blockers in the management of BPH, in which the decision to stop and switch pharmacological treatments is primarily based on changes in symptoms or side effects.

SUBMITTER: Moon HW

PROVIDER: S-EPMC6125595 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Prescription pattern of alpha-blockers for management of lower urinary tract symptoms/benign prostatic hyperplasia.

Moon Hyong Woo HW Yang Jong Hyup JH Choi Jin Bong JB Bae Woong Jin WJ Cho Hyuk Jin HJ Hong Sung-Hoo SH Lee Ji Youl JY Kim Sae Woong SW Park Sang-Hyun SH Han Kyungdo K Ha U-Syn US

Scientific reports 20180905 1

This study investigated trends in the prescription of α-blockers for patients with BPH, focusing on changing patterns of prescriptions during 2002-2013 using National Health Insurance Service-National Sample Cohort data. A total of 65,596 Korean males over 50 years old diagnosed with BPH were identified from the NHIS-NSC database between 2002-2013. Patterns of each α -blocker prescription were analyzed and persistence rate, switch rate, and return rate during a follow-up period of 3 years after ...[more]

PMID: 30185936

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Project description:This study aimed to investigate perceived ejaculatory function/satisfaction before treatment for lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and to identify associations between specific categories of ejaculatory dysfunctions (EjDs) and LUTS. A total of 1574 treatment-naïve men with LUTS/BPH were included in this study. All patients underwent routine evaluation for LUTS/BPH including the International Index of Erectile Function and a 5-item questionnaire developed to assess ejaculatory volume/force/pain/satisfaction/latency time. Patients who had sexual intercourse over the past 4 weeks were classified as sexually active group. A total of 783 patients were categorized as sexually active group. Decreased ejaculatory volume and force were reported by 53.4% and 55.7% of 783 sexually active men, respectively. There was a strong correlation between ejaculatory volume and force. Ejaculatory pain/discomfort, premature ejaculation (PE), and delayed ejaculation (DE) were reported in 41.0%, 16.3%, and 41.4% of the patients, respectively. Over 40.0% of men without decreased ejaculation volume/force were satisfied with ejaculatory function, whereas approximately 6.0% of men with decreased volume/force were satisfied with ejaculatory function. About 30.0% of men with decreased volume/force had orgasmic dysfunction, while approximately 10.0% of men without decreased volume/force did. Decreased ejaculatory volume or force was associated with LUTS severity after adjusting for other influential factors including testosterone level, erectile function, and prostate size on ultrasonography, but PE or DE or ejaculatory pain/discomfort was not. In conclusion, a considerable portion of men with LUTS/BPH appear to have a variety of EjDs. Ejaculatory volume/force and satisfaction/orgasm do not always appear to be concordant. Ejaculatory volume or force is independently associated with LUTS severity, whereas PE or DE or ejaculatory pain/discomfort is not.

Project description:ContextSeveral newer device-based procedures have recently become available for treating men with lower urinary tract symptoms attributed to benign prostatic hyperplasia, but their effectiveness remains uncertain.ObjectiveTo assess the longer-term comparative effectiveness (defined as >12 mo of follow-up) of the newer treatment modalities prostatic urethral lift (PUL), transurethral prostate convective radiofrequency water vapor (Rezūm), Aquablation, and prostatic arterial embolization (PAE).Evidence acquisitionOvid Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Agency for Healthcare Research and Quality databases were searched through September 30, 2019; hand searches of references of relevant studies were also performed. Eligible studies were randomized controlled trials (RCTs) published in English language. We excluded observational studies.Evidence synthesisOne RCT (n = 91) found that patients undergoing PUL may be less likely to respond (risk ratio [RR] 0.8; 95% confidence interval [CI] 0.7-1.0; low certainty of evidence [CoE]) and have a higher mean International Prostate Symptom Score (IPSS; mean difference 6.1; 95% CI 2.2-10.0; low CoE) than those undergoing transurethral resection of the prostate (TURP). Among patients undergoing PAE, one small RCT (n = 30) reported similar IPSS response rates (RR 0.9; 95% CI 0.7-1.1; low CoE) and one trial (n = 107) found similar mean IPSS (-0.7; 95% CI -1.3 to 2.7; moderate CoE) scores to those among patients undergoing TURP. A single study on Aquablation reported 12 mo of follow-up only, and a single 3-mo trial compared Rezūm with sham treatment.ConclusionsThe current best evidence underlying these newer therapies is limited to few trials (PUL and PAE), short-term follow-up of 12 mo (Aquablation and Rezūm), or sham comparison only (Rezūm).Patient summaryEvidence for four of the newer surgical treatments for men with an enlarged prostate is limited to few small trials with short-term follow-up; only one trial compared a new treatment modality with sham surgery.

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Prescription pattern of alpha-blockers for management of lower urinary tract symptoms/benign prostatic hyperplasia.

Publications

Prescription pattern of alpha-blockers for management of lower urinary tract symptoms/benign prostatic hyperplasia.

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