Real-world therapeutic management and evolution of patients with benign prostatic hyperplasia in primary care and urology in Spain.

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.

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.

Overall differences were noticed in the management of patients between healthcare service (p<0.001) and with or without progression criteria (p<0.05). 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 an 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.

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.

International journal of clinical practice. 2021 Apr 22 [Epub ahead of print]

Bernardino Miñana, Jose Maria Molero, Alfonso Agra Rolán, Miguel Tellez Martínez-Fornes, Rafael Cuervo Pinto, David Lorite Mingot, Ágata Carreño, Juan Manuel Palacios-Moreno

Urology Department, University Clinic of Navarra, Pamplona, Spain., Centro de Salud San Andrés, Madrid, Spain., Medical Department, GlaxoSmithKline, Tres Cantos, Spain., Urology, Severo Ochoa University Hospital, Madrid, Spain., Health Economics and Outcomes Research - Real World Insights (HEOR-RWI), IQVIA, Spain., Global Medical Classic and Established Products, GlaxoSmithKline, Tres Cantos, Madrid, Spain.