Treatment patterns in alpha-blocker therapy for benign prostatic hyperplasia.

Abstract

This study examined treatment patterns and patient characteristics of men initiating alpha adrenergic blocker therapy (alpha-blocker) for benign prostatic hyperplasia (BPH). The 2009 Thomson Reuters MarketScan® Database was used to identify the newly initiated alpha-blocker: men ≥40 years old with continuous medical and pharmacy coverage for 12 months before and after alpha-blocker initiation, with no alpha-blocker or 5-alpha-reductase inhibitors in the previous year, and with ≥1 BPH diagnosis within 1 month before and 6 months after alpha-blocker initiation. This study analyzed patient demographics, clinical characteristics, adherence (percentage of men achieving medication possession ratio [MPR] ≥ 0.8), restarting the same alpha-blocker after discontinuation, switching to another BPH medication, and type of alpha-blocker (alpha 1 type selective or alpha 1 subtype selective agents). T tests and chi-square tests compared differences at the .05 significance level. A total of 13,474 men met the study criteria (mean age of 63.1 years). Two thirds of the men discontinued alpha-blocker in the 12-month period, among which restarts or switches were statistically different (p = .036) but numerically similar across cohorts. Adherence for alpha 1 type selective agents versus alpha 1 subtype selective agents at 6 months was 43.3% versus 38.1% (p < .01); at 12 months, 34.4% versus 30.5% (p < .01). Alpha-blocker discontinuation rates were high, which confirms low medication adherence reported among medications for several other chronic conditions; therefore, it is necessary to understand the reasons for alpha-blocker discontinuation.

• Authors: Michael J Schoenfeld, Emily F Shortridge, Steven C Gelwicks, Zhanglin Cui, David G Wong
• Journal: American journal of men's health (Am J Mens Health) Vol. 8 Issue 3 Pg. 267-72 (May 2014) ISSN: 1557-9891 [Electronic] United States
• PMID: 24262787 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• 5-alpha Reductase Inhibitors
• Adrenergic alpha-Antagonists

Topics

• 5-alpha Reductase Inhibitors (administration & dosage)
• Adrenergic alpha-Antagonists (administration & dosage)
• Adult
• Aged
• Databases, Factual
• Demography
• Humans
• Male
• Medication Adherence
• Middle Aged
• Practice Patterns, Physicians'
• Prostatic Hyperplasia (drug therapy)
• Retrospective Studies
• United States