To describe trends in the pharmacological treatment of BPH in the United Kingdom (UK) from 1998 to 2016.
We created a cohort of men with a diagnosis of BPH between 1998 and 2016 using the Clinical Practice Research Datalink. Using Poisson regression, we estimated annual prescription rates of 5αRIs, α-blockers, and combination therapy (5αRIs + α-blockers). Adherence was defined by a proportion of days covered > 80%.
Our cohort included 192,640 men with BPH who generated 1,176,264 person-years (PYs) of follow-up. The mean age was 68.0 (standard deviation: 10.7) years. The prescription rate of all BPH medications during the study period was 347.6 per 100 PYs (95% CI 347.2-347.9). α-Blockers had the highest prescription rate (222.9 per 100 PYs, 95% CI 222.7-223.2); prescription rates of 5αRIs and combination therapy were 69.1 per 100 PYs (95% CI 69.0-69.3) and 55.5 per 100 PYs (95% CI 55.4-55.7), respectively. The prescription rate for combination therapy was 19 times greater in 2013-2016 than in 1998-2000 (rate ratio: 19.2, 95% CI 18.6-19.7), while the prescription rates for 5αRIs and α-blockers each doubled during this period (rate ratio: 1.86, 95% CI 1.84-1.88 and rate ratio: 2.02, 95% CI 2.01-2.04, respectively). The proportion of patients who were adherent at 1 year to 5αRIs (32.3%), α-blockers (44.0%), and combination therapy (45.6%) was low.
The prescription rate of BPH medications increased substantially between 1998 and 2016 in the UK, with the greatest relative increase observed with combination therapy. Adherence to BPH medications was low in this population-based study.
World journal of urology. 2020 Sep 09 [Epub ahead of print]
Henok Tadesse Ayele, Pauline Reynier, Laurent Azoulay, Robert W Platt, Josselin Cabaussel, Serge Benayoun, Kristian B Filion
Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montréal, Canada., Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Canada., Department of Surgery, Urology Unit, Hôpital Maisonneuve-Rosemont, Montréal, Canada., Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montréal, Canada. .