title: Patient satisfaction with testosterone replacement therapies: the reasons behind the choices.
abstract: BACKGROUND
  Testosterone replacement therapy (TRT) for male hypogonadism is rapidly gaining popularity and acceptance. Options include gels, injections, and implantable subcutaneous pellets.
  
  
  OBJECTIVE
  The aim of this study was to determine rates of patient satisfaction and reasons for patient preferences in hypogonadal men on TRT.
  
  
  METHODS
  An anonymous, prospective survey was distributed to men presenting for TRT at an academic urology clinic. The survey was organized into multiple domains including patient satisfaction and treatment motivation.
  
  
  METHODS
  Patient satisfaction responses obtained via anonymous survey.
  
  
  RESULTS
  Average patient age was 49 ± 0.7 years (n = 382). Injectable testosterone was chosen by 53%, gel-based regimens by 31%, and pellets by 17%. Overall, 70% of patients were satisfied with their TRT and 14% reported dissatisfaction. Satisfaction rates were similar between gels (68%), injections (73%), and implantable pellets (70%). Doctor recommendation was the sole significant reason for patients preferring gel-based TRT (66% vs. 37% injection users vs. 31% pellet users). Injectable TRT was favored because of lower cost (35% vs. 21% gel users vs. 19% pellet users). Pellets were favored for ease of use (64% vs. 44% injection users vs. 43% gel users) and convenience (58% vs. 26% injection users vs. 19% gel users). Pellets had increased rates of satisfaction within the first 12 months. Improvements in concentration and mood occurred at higher percentages in satisfied patients.
  
  
  CONCLUSIONS
  Patients are satisfied with TRT. Lower costs are important to patients on injections. Convenience and ease of use are central in choosing pellet therapy. Men on TRT should be questioned about mood and concentration because these factors exhibited the greatest improvements in satisfied patients.
authors.affiliation: Scott Department of Urology and the Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Kovac
authors.forename: Saneal
authors.initials: S
authors.lastname: Rajanahally
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Smith
authors.forename: Robert M
authors.initials: RM
authors.lastname: Coward
authors.forename: Dolores J
authors.initials: DJ
authors.lastname: Lamb
authors.forename: Larry I
authors.initials: LI
authors.lastname: Lipshultz
mesh_terms: D004343:Drug Implants / Q000627:therapeutic use; D005782:Gels; D020249:Hormone Replacement Therapy / Q000191:economics / Q000379:methods* / Q000523:psychology; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D013739:Testosterone / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D004343:Drug Implants; D005782:Gels; D013739:Testosterone
keywords: Male Hypogonadism; Patient Preferences; Patient Satisfaction; Testosterone Replacement Therapy