Treatment Patterns in Alpha-Blocker Therapy for Benign Prostatic Hyperplasia. (May 2014)

• Record Type: Journal Article
• Authors: Schoenfeld, Michael J.; Shortridge, Emily F.; Gelwicks, Steven C.; Cui, Zhanglin; Wong, David G.
• Is Part Of: American journal of men's health. Volume 8:Number 3(2014)
• Page Start: 267
• Page End: 272
• Publication Date: 2014-05
• Subjects: alpha-blocker therapy -- benign prostatic hyperplasia -- medication adherence -- treatment; Men -- Diseases -- Periodicals; Sex factors in disease -- Periodicals; Men -- Health and hygiene -- Periodicals; Men -- Health and hygiene -- United States -- Periodicals; Men -- Medical care -- Periodicals; 362.10811
• DOI: 10.1177/1557988313510732
• Languages: English
• ISSNs: 1557-9883

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.