title: Treatment patterns in alpha-blocker therapy for benign prostatic hyperplasia.
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.
authors.affiliation: 1Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Schoenfeld
authors.forename: Emily F
authors.initials: EF
authors.lastname: Shortridge
authors.forename: Steven C
authors.initials: SC
authors.lastname: Gelwicks
authors.forename: Zhanglin
authors.initials: Z
authors.lastname: Cui
authors.forename: David G
authors.initials: DG
authors.lastname: Wong
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000008:administration & dosage; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D003710:Demography; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D012189:Retrospective Studies; D014481:United States
chemical_list: D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists
keywords: alpha-blocker therapy; benign prostatic hyperplasia; medication adherence; treatment