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Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia.
World J Urol. 2012 Jun; 30(3):419-26.WJ

Abstract

OBJECTIVE

This study's aim was to describe and evaluate outcomes of medical strategies used for lower urinary tract symptoms (LUTS) treatment in general practice and to assess impact of LUTS on patients' general health-related quality of life (HRQoL).

METHODS

This cross-sectional observational study was conducted by French general practitioners. Eligible patients were males aged ≥50 years, diagnosed for at least one year and currently treated for LUTS due to benign prostatic hyperplasia (BPH). Several validated questionnaires were documented by patients to assess severity of LUTS (IPSS), specific quality of life (IPSS-Q8), impact of LUTS (BII), LUTS evolution (VNS) and general HRQoL (EQ-5D).

RESULTS

Among 1,098 patients included, 82.7% were treated with monotherapies and 17.3% with combinations. Mean treatment duration was 5.2 ± 3.2 years, and 47.2% of patients had at least one treatment modification since initiation. Patients reported diminished quality of life (IPSS-Q8 ≥3) (42.3%), persisting symptoms (IPSS-score ≥12) (35.5%), symptoms worsening (VNS-score ≤-1) (18.8%) and high bother (BII-score ≥9) (2.6%). Globally, 52.8% had at least one of these unsatisfactory outcomes. Regarding general HRQoL, mean EQ-5D utility significantly decreased with LUTS severity (mild: 0.90 ± 0.12; moderate: 0.81 ± 0.21; and severe symptoms: 0.73 ± 0.25; P < 0.001). As well, all five-dimensions of EQ-5D were significantly altered in patients with moderate-to-severe LUTS (<0.001), especially 'Pain/Discomfort' and 'Anxiety/Depression'. In multivariate analyses including age and comorbidities, EQ-5D utility index remained negatively associated with each additional unit in the IPSS-score.

CONCLUSIONS

This study shows that around half of BPH patients medically treated report unsatisfactory outcomes, suggesting consequential unmet medical needs in general practice. Also, moderate-to-severe LUTS significantly impact on general HRQoL.

Authors+Show Affiliations

Department of Urology, Centre Hospitalier Auxerre, Auxerre, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

21892656

Citation

Fourcade, Richard-Olivier, et al. "Outcomes and General Health-related Quality of Life Among Patients Medically Treated in General Daily Practice for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia." World Journal of Urology, vol. 30, no. 3, 2012, pp. 419-26.
Fourcade RO, Lacoin F, Rouprêt M, et al. Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia. World J Urol. 2012;30(3):419-26.
Fourcade, R. O., Lacoin, F., Rouprêt, M., Slama, A., Le Fur, C., Michel, E., Sitbon, A., & Cotté, F. E. (2012). Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia. World Journal of Urology, 30(3), 419-26. https://doi.org/10.1007/s00345-011-0756-2
Fourcade RO, et al. Outcomes and General Health-related Quality of Life Among Patients Medically Treated in General Daily Practice for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. World J Urol. 2012;30(3):419-26. PubMed PMID: 21892656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia. AU - Fourcade,Richard-Olivier, AU - Lacoin,François, AU - Rouprêt,Morgan, AU - Slama,Alain, AU - Le Fur,Camille, AU - Michel,Emilie, AU - Sitbon,Axel, AU - Cotté,François-Emery, Y1 - 2011/09/03/ PY - 2011/04/06/received PY - 2011/08/16/accepted PY - 2011/9/6/entrez PY - 2011/9/6/pubmed PY - 2013/1/3/medline SP - 419 EP - 26 JF - World journal of urology JO - World J Urol VL - 30 IS - 3 N2 - OBJECTIVE: This study's aim was to describe and evaluate outcomes of medical strategies used for lower urinary tract symptoms (LUTS) treatment in general practice and to assess impact of LUTS on patients' general health-related quality of life (HRQoL). METHODS: This cross-sectional observational study was conducted by French general practitioners. Eligible patients were males aged ≥50 years, diagnosed for at least one year and currently treated for LUTS due to benign prostatic hyperplasia (BPH). Several validated questionnaires were documented by patients to assess severity of LUTS (IPSS), specific quality of life (IPSS-Q8), impact of LUTS (BII), LUTS evolution (VNS) and general HRQoL (EQ-5D). RESULTS: Among 1,098 patients included, 82.7% were treated with monotherapies and 17.3% with combinations. Mean treatment duration was 5.2 ± 3.2 years, and 47.2% of patients had at least one treatment modification since initiation. Patients reported diminished quality of life (IPSS-Q8 ≥3) (42.3%), persisting symptoms (IPSS-score ≥12) (35.5%), symptoms worsening (VNS-score ≤-1) (18.8%) and high bother (BII-score ≥9) (2.6%). Globally, 52.8% had at least one of these unsatisfactory outcomes. Regarding general HRQoL, mean EQ-5D utility significantly decreased with LUTS severity (mild: 0.90 ± 0.12; moderate: 0.81 ± 0.21; and severe symptoms: 0.73 ± 0.25; P < 0.001). As well, all five-dimensions of EQ-5D were significantly altered in patients with moderate-to-severe LUTS (<0.001), especially 'Pain/Discomfort' and 'Anxiety/Depression'. In multivariate analyses including age and comorbidities, EQ-5D utility index remained negatively associated with each additional unit in the IPSS-score. CONCLUSIONS: This study shows that around half of BPH patients medically treated report unsatisfactory outcomes, suggesting consequential unmet medical needs in general practice. Also, moderate-to-severe LUTS significantly impact on general HRQoL. SN - 1433-8726 UR - https://www.unboundmedicine.com/medline/citation/21892656/Outcomes_and_general_health_related_quality_of_life_among_patients_medically_treated_in_general_daily_practice_for_lower_urinary_tract_symptoms_due_to_benign_prostatic_hyperplasia_ L2 - https://dx.doi.org/10.1007/s00345-011-0756-2 DB - PRIME DP - Unbound Medicine ER -