Problems with administration of international prostate symptom score in a developing community

The IPSS form has been found useful for assessing symptom severity, which assists in treatment choice and in monitoring patients on therapy. The form should be self-administered and requires some level of literacy. We assessed the problems associated with its administration in a developing community.

The IPSS form was administered to patients with benign prostatic hyperplasia at the Urology Clinic of the Jos University Teaching Hospital from November 2004 to October 2005. Those who did not understand the questions or who could not read English required explanations.

There were a total of 70 patients who agreed to fill out the forms. Their ages ranged from 40 to 104 years with a mean of 63.6. The IPSS scores ranged from 3 to 35 with a mean of 18.3. About 56.7% of the patients had quality of life scores of ≥ 5. Only 2 (2.9%) patients were initially uncooperative in filling out the forms. Twenty-four (34.3%) did not understand English. Of the 46 (65.7%) that understood English, 28 (40.0%) could speak but could not read English, thus 52 (74.3%) could not read English. Ten (14.3%) patients thought the questions were either not comprehensive or clear enough.

Illiteracy is a major drawback with the administration of the IPSS form, with 74.3% of patients unable to read English. Attempts should be made to draft the forms in the main language(s) spoken or read in a particular locality so as to gain maximally from the benefits of the IPSS. Relevant bodies should improve on the education of the populace.