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

Michael J Schoenfeld1, Emily F Shortridge, Steven C Gelwicks

  • 11Eli Lilly and Company, Indianapolis, IN, USA.

American Journal of Men'S Health
|November 23, 2013
PubMed
Summary

High discontinuation rates were observed for alpha-blocker therapy in men with benign prostatic hyperplasia (BPH). Adherence varied between selective and subtype selective agents, highlighting the need to understand discontinuation reasons.

Keywords:
alpha-blocker therapybenign prostatic hyperplasiamedication adherencetreatment

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Area of Science:

  • Urology
  • Pharmacology
  • Health Services Research

Background:

  • Benign prostatic hyperplasia (BPH) is a common condition in aging men.
  • Alpha-blockers are a primary pharmacotherapy for BPH symptoms.

Purpose of the Study:

  • To examine treatment patterns and patient characteristics of men initiating alpha-blocker therapy for BPH.
  • To assess adherence and discontinuation rates of alpha-blockers in a real-world setting.

Main Methods:

  • Retrospective analysis of the 2009 Thomson Reuters MarketScan® Database.
  • Inclusion criteria: men ≥40 years old with continuous coverage and BPH diagnosis, initiating alpha-blocker therapy.
  • Analysis of demographics, adherence (MPR ≥ 0.8), restarts, switches, and alpha-blocker type.

Main Results:

  • 13,474 men met the study criteria (mean age 63.1 years).
  • Two-thirds of men discontinued alpha-blocker therapy within 12 months.
  • Adherence at 6 months: 43.3% (alpha 1 type selective) vs. 38.1% (alpha 1 subtype selective); at 12 months: 34.4% vs. 30.5% (p < .01 for both).

Conclusions:

  • Alpha-blocker discontinuation rates are high, similar to other chronic condition medications.
  • Understanding reasons for discontinuation is crucial for improving BPH management.
  • Adherence differs between alpha-blocker subclasses.