Prescription patterns of alpha-blockers in Dutch men suffering lower urinary tract symptoms

Hordijk, I.M.J. (2016) Prescription patterns of alpha-blockers in Dutch men suffering lower urinary tract symptoms. thesis, Medicine.

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Abstract

Background α-Blockers are the first choice of pharmacological treatment in men with LUTS. The Dutch guideline for GPs advises to discontinue treatment after 3-6 months and evaluate symptoms. The guideline for urologists does not support this recommendation. It is unclear if the difference in guideline advices leads to different prescription patterns. Objectives To examine α-blocker prescription patterns among Dutch men within the first year of treatment. To analyse whether patients had a period of discontinuation during treatment, as advised in the Dutch GP guideline. To evaluate if the prescription patterns of urologist’s and GP’s patients are different. Materials and methods We performed a retrospective analysis using data from the IADB.nl prescription database. Men aged ≥ 30 years, with an α-blocker prescription between 2006 and 2013, without prescription in the two preceding years, were included. (Temporary) discontinuation rates were analysed at 2, 6, 13, 26, 39 and 52 weeks after treatment initiation for GP’s and urologist’s patients and among age groups. Differences were compared using the Chi2 test. Binary logistic regression analysis was used to investigate factors associated with continued α-blocker use after 1 year. Results In total, 12,191 patients were included, 6,772 from GPs and 5,419 from urologists. The mean age was 65.3 years at time of first α-blocker prescription. The mean treatment duration was 575 and 516 days for GP’s and urologist’s patients respectively. Within one year, 63% of all men discontinued treatment, 66% and 60% for GP’s and urologist’s patients respectively. Thirty percent of all current users at one year had a period of discontinuation. We found no clinically relevant difference in prescription patterns according to the first prescriber. Conclusion The overall discontinuation rate within 1 year of treatment was 63%. Only 30% of the current users at 1 year after initiation have had a period of discontinuation. We did not find relevant differences in prescription patterns between GPs and urologists.

Item Type:	Thesis (Thesis)
Supervisor name:	Blanker, Dr. M.H. and UMC Groningen and Location: University Medical Center Groningen (UMCG) and Department of General Practice
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:42
Last Modified:	25 Jun 2020 10:42
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/368

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