Poor clinical guideline adherence and inappropriate testing for incident lower urinary tract symptoms associated with benign prostatic hyperplasia.
Prostate Cancer Prostatic Dis
; 25(2): 269-273, 2022 02.
Article
de En
| MEDLINE
| ID: mdl-34545201
ABSTRACT
BACKGROUND:
The American Urological Association makes recommendations for evaluation and testing for lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) to help primary care providers and specialists identify LUTS/BPH and harmful related conditions including urinary retention and prostate or bladder cancer. Our understanding of provider adherence to these Guidelines is limited to single-site or nonrepresentative settings.METHODS:
We analyzed two insurance claims databases the Optum® de-identified Clinformatics® Data Mart database for privately insured males aged 40-64 years (N ≈ 1,650,900 annually) and the Medicare 5% Sample for males aged ≥65 years (N ≈ 546,000 annually). We calculated the annual prevalence of LUTS/BPH and comorbid bladder cancer and bladder stones from 2004 to 2013. We additionally examined LUTS/BPH incidence and adherence to testing guidelines in a cohort of men newly diagnosed with LUTS/BPH in 2009.RESULTS:
While LUTS/BPH prevalence and incidence increased with increasing age, evaluation testing became less common. Urinalysis was the most common testing type but was performed in <60% of incident patients. Serum prostate-specific antigen (PSA) was the second most common test across age groups (range 15-34%). Prevalence of comorbid bladder cancer (range 0-4%), but not bladder stones (range 1-2%), increased with increasing age.CONCLUSIONS:
Although older men were at greater risk of LUTS/BPH than younger men, they were less likely to undergo testing at diagnosis. Recommended testing with urinalysis was poor despite higher prevalence of bladder cancer in older men and a standard recommendation for urinalysis since 1994. Providers should be more cognizant of AUA Guidelines when assessing LUTS/BPH patients.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Hyperplasie de la prostate
/
Tumeurs de la prostate
/
Tumeurs de la vessie urinaire
/
Symptômes de l'appareil urinaire inférieur
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Aged
/
Humans
/
Male
Pays/Région comme sujet:
America do norte
Langue:
En
Journal:
Prostate Cancer Prostatic Dis
Sujet du journal:
ENDOCRINOLOGIA
/
NEOPLASIAS
/
UROLOGIA
Année:
2022
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique