Portal de Periódicos da CAPES

Evaluating Use Patterns of and Adherence to Medications for Benign Prostatic Hyperplasia

2009; Lippincott Williams & Wilkins; Volume: 181; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2009.01.033

1527-3792

Michael B. Nichol, Tara K. Knight, Joanne Wu, Richard Barron, David F. Penson,

Sexual function and dysfunction studies

No AccessJournal of UrologyAdult Urology1 May 2009Evaluating Use Patterns of and Adherence to Medications for Benign Prostatic Hyperplasia Michael B. Nichol, Tara K. Knight, Joanne Wu, Richard Barron, and David F. Penson Michael B. NicholMichael B. Nichol Department of Clinical Pharmacy and Pharmaceutical Economics and Policy, University of Southern California, Los Angeles, California , Tara K. KnightTara K. Knight Department of Clinical Pharmacy and Pharmaceutical Economics and Policy, University of Southern California, Los Angeles, California , Joanne WuJoanne Wu Department of Clinical Pharmacy and Pharmaceutical Economics and Policy, University of Southern California, Los Angeles, California , Richard BarronRichard Barron Allergan Corp., Irvine, California , and David F. PensonDavid F. Penson Department of Urology, University of Southern California, Los Angeles, California View All Author Informationhttps://doi.org/10.1016/j.juro.2009.01.033AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated adherence to benign prostatic hyperplasia medications in a California Medicaid population. Materials and Methods: Using California Medicaid data on 1995 to 2004 we identified adult males 40 years old or older with 1 or more diagnosis and 2 or more prescription fills for benign prostatic hyperplasia. Patients with 2 fills on the same day were assigned to the multiple medication cohort. Adherence was measured using the medication possession ratio for the index medication and the proportion of days covered for any benign prostatic hyperplasia medication. Patients with a medication possession ratio or proportion of days covered of 0.8 or greater were considered adherent. A Cox proportional hazards model was used to assess the relative hazards associated with discontinuation. Multiple logistic regression was used to investigate factors associated with nonadherence or a benign prostatic hyperplasia related procedure. Results: Of the total population of 2,640 men 40% were adherent with any benign prostatic hyperplasia medication. A significantly greater proportion of patients using multiple medications and finasteride were adherent with any benign prostatic hyperplasia medication (62% and 55%, respectively, p <0.0001). Doxazosin, terazosin and tamsulosin use was associated with nonadherence (p = 0.008, 0.04 and 0.03, respectively). Younger patients and those changing medications were more likely to discontinue (p = 0.01 and <0.0001), while patients using multiple medications and those experiencing a gap were at lower risk for discontinuation (p = 0.01 and <0.0001, respectively). Predictors of a procedure included an index prescription in 1999 or later, a urologist visit and nonadherence to any benign prostatic hyperplasia medication (p = 0.01, <0.0001 and <0.0001, respectively). Conclusions: Adherence to α-blockers was less than adherence to finasteride or multiple medications and nonadherence was significantly associated with a procedure. Interventions focused on improving adherence to benign prostatic hyperplasia medications are clearly needed. References 1 : Changing therapeutic regimens in benign prostatic hyperplasia. Pharmacoeconomics2001; 19: 131. Google Scholar 2 : The progression of benign prostatic hyperplasia: examining the evidence and determining the risk. Eur Urol2001; 39: 390. Google Scholar 3 : Optimising the medical management of benign prostatic hyperplasia. Eur Urol2004; 45: 411. Google Scholar 4 : Impact of treatment on sexuality. Prostate Cancer Prostatic Dis2001; 4: S12. Google Scholar 5 : Medical management of BPH: the debate continues. Eur Urol2006; 50: 416. Google Scholar 6 : Role of the newer alpha, adrenergic receptor antagonists in the treatment of benign prostatic hyperplasia related lower urinary tract symptoms. Clin Ther2004; 26: 1701. Google Scholar 7 : The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia: Finasteride Long Term Efficacy and Safety Group. N Engl J Med1998; 338: 557. Google Scholar 8 : Treatment strategies, patterns of drug use and treatment discontinuation in men with LUTS suggestive of benign prostatic hyperplasia: the Triumph Project. Eur Urol2003; 44: 539. Google Scholar 9 : Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol1992; 45: 613. Google Scholar 10 : A checklist for medication compliance and persistence studies using retrospective databases. Value Health2006; 10: 3. Google Scholar 11 : Long-term persistence in the use of statin therapy in elderly patients. JAMA2002; 288: 455. Google Scholar 12 : Persistence of use in lipid-lowering medications: a cross national study. JAMA1998; 279: 1458. Google Scholar 13 : Alternatives to TURP: outcome analysis and indication tuning. Eur Urol2002; 42: I. Google Scholar 14 : 5-Alpha reductase inhibition provides superior benefits to alpha blockade by preventing AUR and BPH-related surgery. Eur Urol2004; 45: 620. Google Scholar 15 : Terazosin in benign prostatic hyperplasia: effects on blood pressure in normotensive and hypotensive men. BJU1998; 82: 373. Google Scholar 16 : Tolerability of a alpha-blockade with doxazosin as a therapeutic option for symptomatic benign prostatic hyperplasia in the elderly patient: a pooled analysis of seven double-blind, placebo-controlled studies. J Gerontol A Biol Sci Med Sci1998; 53: M201. Google Scholar 17 : The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med2003; 349: 2387. Google Scholar 18 : Predictors of adherence with antihypertensive and lipid-lowering therapy. Arch Int Med2005; 165: 1147. Google Scholar 19 : Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA2002; 288: 462. Google Scholar 20 : Polypharmacy and medication adherence in patients with type 2 diabetes. Diabetes Care2003; 26: 1408. Google Scholar 21 : Drug treatment of benign prostatic hyperplasia and hospital admission for BPH-related procedure. Eur Urol2003; 43: 528. Google Scholar 22 : Long term results of medical treatment in benign prostatic hyperplasia. Urology2006; 68: 1015. Google Scholar 23 : An examination of treatment patterns and costs of care among patients with benign prostatic hyperplasia. Am J Manag Care2006; 12: S99. Google Scholar 24 : Comparison of prescription and medical records in reflecting patient antihypertensive drug therapy. Pharmacotherapy1994; 28: 99. Google Scholar 25 : Validation of patient reports, automated pharmacy records, and pill counts with electronic monitoring of adherence to antihypertensive therapy. Med Care1999; 37: 846. Google Scholar © 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byGupta N, Rogers T, Holland B, Helo S, Dynda D and McVary K (2018) Three-Year Treatment Outcomes of Water Vapor Thermal Therapy Compared to Doxazosin, Finasteride and Combination Drug Therapy in Men with Benign Prostatic Hyperplasia: Cohort Data from the MTOPS TrialJournal of Urology, VOL. 200, NO. 2, (405-413), Online publication date: 1-Aug-2018.Kaplan S (2018) Re: Drug Adherence and Clinical Outcomes for Patients under Pharmacological Therapy for Lower Urinary Tract Symptoms Related to Benign Prostatic Hyperplasia: Population-Based Cohort StudyJournal of Urology, VOL. 197, NO. 2, (483-484), Online publication date: 1-Feb-2017.Roehrborn C, Gange S, Gittelman M, Goldberg K, Patel K, Shore N, Levin R, Rousseau M, Beahrs J, Kaminetsky J, Cowan B, Cantrill C, Mynderse L, Ulchaker J, Larson T, Dixon C and McVary K (2018) Convective Thermal Therapy: Durable 2-Year Results of Randomized Controlled and Prospective Crossover Studies for Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic HyperplasiaJournal of Urology, VOL. 197, NO. 6, (1507-1516), Online publication date: 1-Jun-2017.Griebling T (2018) Re: Initial Treatment of Men with Newly Diagnosed Lower Urinary Tract Dysfunction in the Veterans Health AdministrationJournal of Urology, VOL. 195, NO. 2, (423-424), Online publication date: 1-Feb-2016.Wein A (2018) Re: Drug Adherence and Clinical Outcomes for Patients under Pharmacological Therapy for Lower Urinary Tract Symptoms Related to Benign Prostatic Hyperplasia: Population-Based Cohort StudyJournal of Urology, VOL. 195, NO. 6, (1831-1832), Online publication date: 1-Jun-2016. Volume 181Issue 5May 2009Page: 2214-2222 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsMedicaidmedication adherenceprostatic hyperplasiaprostateadrenergic alpha-antagonistsMetricsAuthor Information Michael B. Nichol Department of Clinical Pharmacy and Pharmaceutical Economics and Policy, University of Southern California, Los Angeles, California Financial interest and/or other relationship with Novartis and Pfizer. More articles by this author Tara K. Knight Department of Clinical Pharmacy and Pharmaceutical Economics and Policy, University of Southern California, Los Angeles, California More articles by this author Joanne Wu Department of Clinical Pharmacy and Pharmaceutical Economics and Policy, University of Southern California, Los Angeles, California More articles by this author Richard Barron Allergan Corp., Irvine, California Financial interest and/or other relationship with Allergan. More articles by this author David F. Penson Department of Urology, University of Southern California, Los Angeles, California More articles by this author Expand All Advertisement PDF downloadLoading ...