Patient’s and physician’s behavior on the management of benign prostatic hyperplasia among the patients at the risk of clinical progression. A multicenter noninterventional trial in Slovakia by “Prostate and Expectations of Treatment: Epidemiology Research” (PETER) study group

Abstract

Our research reflects the physician's behavior, patient's self-perception of the disease and therapeutic priorities in the current outpatient practice in Slovakia.

A Systematic Review of Patients’ Values, Preferences, and Expectations for the Diagnosis and Treatment of Male Lower Urinary Tract Symptoms

“…Men expect to be prescribed pharmacological treatments for LUTS (the single most common answer; 43%), especially if their symptoms are severe, and expect pharmacological treatments to reduce voiding symptoms [36]. Rapid symptom improvement: 4 studies reported on the proportion of patients preferring a medication with rapid symptom relief [15,22,32,33]; 62-97% preferred a treatment that provided rapid improvement in symptoms (within a few weeks to months) [15,22].…”

“…Efficacy: One study comparing tamsulosin and silodosin reported a preference for tamsulosin due to good efficacy in 27% (vs 13%) [30].However, 93% would stop a-blocker Stabilisation of disease: 2 forced choice studies reported that 36-38% of men preferred a treatment that stabilised symptoms and the disease [32,33]. One study reported that 76% were willing to take two medications to provide symptom relief and that 64% were willing to wait 3 mo for symptom improvement in preference for a medication that provides long-term treatment of the underlying condition [22].…”

“…Willingness to pay: Sexual adverse events: -For a treatment with no side effect of impotence: s418/£30-66 -For a treatment with no side effect of reduced libido: s237/£20-46 -For a treatment with no side effect of abnormal ejaculation: s163 /£17-34 Nonsexual adverse events: -For a treatment with no side effect of dizziness: s70/£17-40 -For a treatment with no side effect of headache: s93/£16 Reduced risk of surgery: -On forced choice, 24-27% prefer a treatment that reduces the risk of future surgery [19,32,33].…”

“…Fifteen studies reported on expectations or preferences related to pharmacological treatment [15,[17][18][19][20]22,27,28,[30][31][32][33][34]36,40]. Principal themes related to (1) efficacy of treatment, (2) effect on stabilising the underlying disease process, (3) type of adverse events, (4) prevention of complications of benign prostatic hyperplasia, and ( 5) burden/cost of treatment (Tables 3 and 5).…”

“…Time to onset of symptom improvement was less of a concern. Survey-based studies reported that 34-97% preferred a treatment that provided rapid symptom improvement within a few weeks to months [15,22,32,33]. In a US survey, 64% of men preferred disease stabilisation to rapid symptom improvement and 69% of men were willing to take two medications to provide symptom relief [22].…”