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Profile and management of patients treated for the first time for lower urinary tract symptoms/benign prostatic hyperplasia in four European countries.
BJU Int. 2008 May; 101(9):1111-8.BI

Abstract

OBJECTIVE

To describe the profile and management of patients medically treated for benign prostatic hyperplasia (BPH) in primary care in four European countries, as the diagnosis and management of BPH have developed dramatically in the last decade, and recent information from actual practice is insufficient.

PATIENTS AND METHODS

This observational, cross-sectional study was carried out by general practitioners in France (141 patients), Spain (127) and Portugal (50), and by office-based urologists in Germany (162 patients) between July 2005 and June 2006. The physicians were unaware of the study sponsor. Patients aged >or=50 years were recruited if a decision for medical treatment of BPH was taken for the first time on that day. The patient and the investigator had to complete one questionnaire each.

RESULTS

The physicians included 480 patients, with a mean (sd) age of 65.0 (7.8) years. The mean (sd) International Prostate Symptom Score (IPSS) was 16.0 (7.3). There were geographical differences in age (P = 0.009; patients in Germany being the youngest), IPSS (P = 0.017; patients in Spain having the highest score), quality of life (QoL; IPSS item 8, P < 0.001, the least altered being in Germany), and sexual activity (P = 0.010; the highest proportion of sexually active patients being in Portugal), but not for comorbidities and concomitant medication. The IPSS correlated poorly with age (r = 0.21) and moderately with QoL (r = 0.47). Severe symptoms (IPSS > 19) were not linked with sexual activity (age-adjusted P = 0.378). Serum prostate specific antigen testing, although not recommended for BPH, was widely used (83.8% overall). All other examinations were carried out disparately depending on the country (P < 0.001 each). Digital rectal examination (DRE) and excluding urinary tract infection (urine culture) were used in approximately 75% of study patients, but only half the patients in France had a urine culture, and 52% in Portugal had a DRE. A standardized assessment of symptoms and/or QoL was reported in 45% of study patients, with wide discrepancies among countries, i.e. 77.2% in Germany and 6.0% in Portugal. alpha-blocker monotherapy was the most frequently prescribed treatment (62.5% overall, 87.1% in Germany, 46.1% in France), followed by phytotherapy (23.5%), and 5 alpha-reductase inhibitor monotherapy (3.75%); combinations were rare. Treatment varied according to the severity of the symptoms (P = 0.008), phytotherapy being given to patients with the lowest IPSS, and combinations to those with the highest IPSS.

CONCLUSION

There were geographical discrepancies that could be attributed to either different cultural habits or merely organisational differences, e.g. the presence of office urologists in Germany or diverse modes of access to phytotherapy (prescription vs 'over the counter') in the various countries.

Authors+Show Affiliations

Department of Urology, Hospital of Auxerre, Auxerre, France. rfourcade@fc.horus-medical.frNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18279447

Citation

Fourcade, Richard-Olivier, et al. "Profile and Management of Patients Treated for the First Time for Lower Urinary Tract Symptoms/benign Prostatic Hyperplasia in Four European Countries." BJU International, vol. 101, no. 9, 2008, pp. 1111-8.
Fourcade RO, Théret N, Taïeb C, et al. Profile and management of patients treated for the first time for lower urinary tract symptoms/benign prostatic hyperplasia in four European countries. BJU Int. 2008;101(9):1111-8.
Fourcade, R. O., Théret, N., & Taïeb, C. (2008). Profile and management of patients treated for the first time for lower urinary tract symptoms/benign prostatic hyperplasia in four European countries. BJU International, 101(9), 1111-8. https://doi.org/10.1111/j.1464-410X.2008.07498.x
Fourcade RO, et al. Profile and Management of Patients Treated for the First Time for Lower Urinary Tract Symptoms/benign Prostatic Hyperplasia in Four European Countries. BJU Int. 2008;101(9):1111-8. PubMed PMID: 18279447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Profile and management of patients treated for the first time for lower urinary tract symptoms/benign prostatic hyperplasia in four European countries. AU - Fourcade,Richard-Olivier, AU - Théret,Nathalie, AU - Taïeb,Charles, AU - ,, Y1 - 2008/02/15/ PY - 2008/2/19/pubmed PY - 2008/5/23/medline PY - 2008/2/19/entrez SP - 1111 EP - 8 JF - BJU international JO - BJU Int VL - 101 IS - 9 N2 - OBJECTIVE: To describe the profile and management of patients medically treated for benign prostatic hyperplasia (BPH) in primary care in four European countries, as the diagnosis and management of BPH have developed dramatically in the last decade, and recent information from actual practice is insufficient. PATIENTS AND METHODS: This observational, cross-sectional study was carried out by general practitioners in France (141 patients), Spain (127) and Portugal (50), and by office-based urologists in Germany (162 patients) between July 2005 and June 2006. The physicians were unaware of the study sponsor. Patients aged >or=50 years were recruited if a decision for medical treatment of BPH was taken for the first time on that day. The patient and the investigator had to complete one questionnaire each. RESULTS: The physicians included 480 patients, with a mean (sd) age of 65.0 (7.8) years. The mean (sd) International Prostate Symptom Score (IPSS) was 16.0 (7.3). There were geographical differences in age (P = 0.009; patients in Germany being the youngest), IPSS (P = 0.017; patients in Spain having the highest score), quality of life (QoL; IPSS item 8, P < 0.001, the least altered being in Germany), and sexual activity (P = 0.010; the highest proportion of sexually active patients being in Portugal), but not for comorbidities and concomitant medication. The IPSS correlated poorly with age (r = 0.21) and moderately with QoL (r = 0.47). Severe symptoms (IPSS > 19) were not linked with sexual activity (age-adjusted P = 0.378). Serum prostate specific antigen testing, although not recommended for BPH, was widely used (83.8% overall). All other examinations were carried out disparately depending on the country (P < 0.001 each). Digital rectal examination (DRE) and excluding urinary tract infection (urine culture) were used in approximately 75% of study patients, but only half the patients in France had a urine culture, and 52% in Portugal had a DRE. A standardized assessment of symptoms and/or QoL was reported in 45% of study patients, with wide discrepancies among countries, i.e. 77.2% in Germany and 6.0% in Portugal. alpha-blocker monotherapy was the most frequently prescribed treatment (62.5% overall, 87.1% in Germany, 46.1% in France), followed by phytotherapy (23.5%), and 5 alpha-reductase inhibitor monotherapy (3.75%); combinations were rare. Treatment varied according to the severity of the symptoms (P = 0.008), phytotherapy being given to patients with the lowest IPSS, and combinations to those with the highest IPSS. CONCLUSION: There were geographical discrepancies that could be attributed to either different cultural habits or merely organisational differences, e.g. the presence of office urologists in Germany or diverse modes of access to phytotherapy (prescription vs 'over the counter') in the various countries. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/18279447/Profile_and_management_of_patients_treated_for_the_first_time_for_lower_urinary_tract_symptoms/benign_prostatic_hyperplasia_in_four_European_countries_ L2 - https://doi.org/10.1111/j.1464-410X.2008.07498.x DB - PRIME DP - Unbound Medicine ER -