title: Burden of benign prostatic hyperplasia among men in Japan: Patient-reported outcomes among those diagnosed and experiencing symptoms.
abstract: OBJECTIVE
  To quantify the burden of benign prostatic hyperplasia among Japanese men according to patient-reported outcomes. A secondary aim was to quantify the incremental burden of nocturia among these men.
  
  
  METHODS
  Survey data representative of the Japanese population by age and sex were analyzed (total n = 59 997). All measures were self-reported, including the revised Medical Outcomes Study 12-Item Short Form Health Survey or the revised Medical Outcomes Study 36-Item Short Form Health Survey, Work Productivity and Activity Impairment questionnaire, and 6-month healthcare use. Men aged ≥50 years were organized into three analysis groups according to diagnosis of benign prostatic hyperplasia and International Prostate Symptom Score total: diagnosed benign prostatic hyperplasia (n = 1183); undiagnosed benign prostatic hyperplasia with moderate to severe symptoms (International Prostate Symptom Score total ≥8; n = 3141); and controls (no benign prostatic hyperplasia diagnosis and International Prostate Symptom Score total <8; n = 9468). Subgroup analyses were carried out according to frequency of nocturia. Generalized linear models adjusted for potential confounders.
  
  
  RESULTS
  Relative to controls, diagnosed and undiagnosed benign prostatic hyperplasia respondents had reduced health-related quality of life, with mean decrements of ≥3.1 points for mental component summary scores, ≥2.0 for physical component summary scores and ≥0.05 for health utility scores (all P < 0.001). Mean absenteeism, impairment at work and non-work activity impairment among the diagnosed and undiagnosed groups were ≥1.4-fold those of the control group (P < 0.01). Both diagnosed and undiagnosed groups used significantly more healthcare than controls. The outcomes of undiagnosed men were worse than diagnosed patients on many measures. Frequent nocturia (≥3 voids per night) was associated with worse health-related quality of life.
  
  
  CONCLUSIONS
  Benign prostatic hyperplasia impacts health-related quality of life, work productivity and healthcare use of Japanese men, with more impact among undiagnosed men experiencing lower urinary tract symptoms and frequent nocturia.
authors.affiliation: National Center for Geriatrics and Gerontology, Obu City, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Kantar Health, Los Angeles, California, USA.
authors.forename: Natalia M
authors.initials: NM
authors.lastname: Flores
authors.affiliation: Kantar Health, Milan, Italy.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Vietri
authors.affiliation: Eli Lilly Japan K.K., Kobe, Japan.
authors.forename: Matthew
authors.initials: M
authors.lastname: Lee
authors.affiliation: Eli Lilly Japan K.K., Kobe, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Murakami
mesh_terms: D000041:Absenteeism; D000368:Aged; D016022:Case-Control Studies; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004526:Efficiency; D006295:Health Resources / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000209:etiology* / Q000523:psychology; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D011788:Quality of Life; D057566:Self Report; D012720:Severity of Illness Index; D063189:Symptom Assessment
keywords: employment; erectile dysfunction; nocturia; prostatic hyperplasia; quality of life