title: Reasons for prescription change of α1-blockers in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
abstract: OBJECTIVE
  To investigate the reasons for prescription change of α1-blockers in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
  
  
  METHODS
  The ratio and interval of prescription change were assessed in 3200 patients who were eligible for the study and took 1 of 4 different α1-blockers (doxazosin, alfuzosin, tamsulosin, or silodosin). The reasons for prescription change and evaluation of efficacy were analyzed in 444 patients whose medical records were complete.
  
  
  RESULTS
  Prescription change to another α1-blocker occurred in 694 of 3200 patients (21.7%), and the mean duration of taking their first α1-blocker was 10.8 ± 8.2 weeks. Lack of efficacy (52.7%) was the main reason for changing α1-blockers, followed by adverse events (33.1%), relatively high cost compared with other α1-blockers (7.0%), inconvenience of taking drugs (4.1%), and cardiovascular comorbidity (3.2%). The mean duration of treatment according to each reason is as follows: increased adverse events: 6.3 ± 5.2 weeks, relatively high cost compared with other α1-blockers: 8.7 ± 4.5 weeks, cardiovascular comorbidity: 10.5 ± 6.8 weeks, inconvenience of taking drugs: 10.8 ± 3.9 weeks, and lack of efficacy: 14.8 ± 6.8 weeks. The proportion of prescription change (16.3%) and prescription change because of hemodynamic adverse events (2.4%) in the silodosin group were low compared with those in the other groups (P <.05 and P <.006, respectively), but prescription change because of a ejaculation disorder was high in the silodosin group (30.1%, P <.001).
  
  
  CONCLUSIONS
  Major reasons for prescription change in patients taking α1-blockers were lack of efficacy and adverse events. In the silodosin group, the proportion of prescription change was significantly low compared with that in the other 3 groups.
authors: Department of Urology, Medical Research Institute, Pusan National University Hospital, Pusan, Korea.
authors: Tae Nam
authors: TN
authors: Kim
authors: Department of Urology, Yangsan Pusan National University Hospital, Yangsan, Korea.
authors: Jong Kil
authors: JK
authors: Nam
authors: Department of Urology, Dong-a University Hospital, Pusan, Korea.
authors: Ki Soo
authors: KS
authors: Lee
authors: Department of Urology, Dong-a University Hospital, Pusan, Korea.
authors: Tae Hyo
authors: TH
authors: Kim
authors: Department of Urology, Yangsan Pusan National University Hospital, Yangsan, Korea.
authors: Sung Woo
authors: SW
authors: Park
authors: Department of Urology, Medical Research Institute, Pusan National University Hospital, Pusan, Korea.
authors: Dong Gil
authors: DG
authors: Shin
authors: Department of Urology, Medical Research Institute, Pusan National University Hospital, Pusan, Korea.
authors: Hyun Jun
authors: HJ
authors: Park
authors: Department of Urology, Cancer Center, Dongnam Institute of Radiological & Medical Science, Pusan, Korea.
authors: Wan
authors: W
authors: Lee
authors: Department of Urology, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. Electronic address: toohotman@hanmail.net.
authors: Zeong Zoo
authors: ZZ
authors: Lee
authors: Department of Urology, Yangsan Pusan National University Hospital, Yangsan, Korea.
authors: Moon Kee
authors: MK
authors: Chung
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D057915:Drug Substitution / Q000706:statistics & numerical data*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications*; D012189:Retrospective Studies
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists