title: Association of physician specialty and medical therapy for benign prostatic hyperplasia.
abstract: BACKGROUND
  Despite little available evidence to determine whether recently introduced selective α-1 blockers and 5-α reductase inhibitors (5-ARIs) are superior to the existing agents in treating benign prostatic hyperplasia (BPH), they are being increasingly prescribed.
  
  
  OBJECTIVE
  To describe the prescribing patterns of new and existing agents among patients with incident BPH after the introduction of several new agents and determine whether these varied by physician specialty.
  
  
  METHODS
  We analyzed a retrospective cohort from an administrative claims database from January 2004 through December 2010.
  
  
  METHODS
  Patients diagnosed with incident BPH aged 40 years and above and those who received medical management.
  
  
  METHODS
  Receipt of medical therapy for incident BPH (ie, selective α-1 blockers [prazosin (released 1976), terazosin (1987), doxazosin (1990), tamsulosin (1997), alfuzosin (2003), silodosin (2009)] and 5-ARIs [finasteride (1992) and dutasteride (2002)]).
  
  
  RESULTS
  A total of 42,769 men with incident BPH received any selective α-1 blocker or 5-ARI. Tamsulosin and dutasteride were the most widely prescribed agents of their respective drug classes. Predicted probabilities showed that urologists were more likely to prescribe alfuzosin (24.0% vs. 7.8%; P<0.001) and silodosin (2.3% vs. 0.4%; P<0.001) when compared with primary care providers (PCPs) at 6 months after diagnosis. Urologists were more likely to prescribe 5-ARIs but less likely to prescribe older α-1 blockers (terazosin, prazosin, and doxazosin) than PCPs at 6 months postdiagnosis.
  
  
  CONCLUSIONS
  Among insured patients diagnosed with BPH, our study suggests that the overall use of new agents is rising. In particular, urologists were more likely to prescribe newer selective α-1 blockers compared with PCPs.
authors.affiliation: *Department Administrative Services-Research, Mayo Clinic, Rochester, MN †Department of Urology, Yale University School of Medicine ‡Cancer Outcomes Public Policy and Effectiveness Research Center, Yale University §Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT ∥Division of Health Care Policy & Research, Mayo Clinic, Rochester, MN ¶Division of Urologic Oncology, Fox Chase Cancer Center-Temple University Health System, Philadelphia, PA #Department of Urology, Mayo Clinic, Rochester, MN.
authors.forename: Leona C
authors.initials: LC
authors.lastname: Han
authors.forename: Simon P
authors.initials: SP
authors.lastname: Kim
authors.forename: Cary P
authors.initials: CP
authors.lastname: Gross
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Ross
authors.forename: Holly K
authors.initials: HK
authors.lastname: Van Houten
authors.forename: Marc C
authors.initials: MC
authors.lastname: Smaldone
authors.forename: Amy E
authors.initials: AE
authors.lastname: Krambeck
authors.forename: Nilay D
authors.initials: ND
authors.lastname: Shah
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D005194:Family Practice / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D012189:Retrospective Studies; D014572:Urology / Q000706:statistics & numerical data
chemical_list: D058891:5-alpha Reductase Inhibitors; D058668:Adrenergic alpha-1 Receptor Antagonists