title: Nocturia is often inadequately assessed, diagnosed and treated by physicians: results of an observational, real-life practice database containing 8659 European and US-American patients.
abstract: OBJECTIVE
  The aim of this study was to investigate the quality and timing of the diagnosis and treatment of nocturia in real-life practice in European and US-American patients to obtain better insights into the management of nocturia in different Western healthcare systems.
  
  
  METHODS
  Data were drawn from the "LUTS Disease Specific Programme," a real-life survey of physicians and patients in France, Germany, Spain, UK and the USA. Physicians completed a patient record form for lower urinary tract symptoms (LUTS) patients. Patients filled out a self-completion form, indicating - among other items - information on the mean number of day- and night-time voids during the last 7 days, and questions on the management of LUTS in daily practice.
  
  
  RESULTS
  In total, 8659 patients were analysed. The majority of patients initially consulted a physician because of worsening of LUTS frequency (43%-58%) or severity (44%-55%). Only 37% of all LUTS diagnoses, regardless of the appearance or severity of nocturia, were based on bladder diaries. Patients took approximately 1 year to consult a medical professional following the onset of LUTS. At the initial visit, most patients received advice on behavioural strategies. Regardless the type of LUTS and physician, 59% of men received α-blockers and 76% of women antimuscarinics.
  
  
  CONCLUSIONS
  Data show that patients with nocturia and LUTS accept their symptoms for a considerable period before they seek help or ultimately receive treatment. They may therefore be enduring significant negative impact on their quality-of-life which could be avoided. Physicians rarely use bladder diaries and primarily use antimuscarinics (women) or α-blockers (men). Improved awareness of nocturia among patients and physicians could improve the management of nocturia.
authors.affiliation: Department of Urology and Urological Oncology, Hannover Medical School, Hannover, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Oelke
authors.affiliation: Adelphi Real World, Bollington, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Anderson
authors.affiliation: Adelphi Real World, Bollington, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Wood
authors.affiliation: Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.|Nopia Research Group, Department of Urology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Tove
authors.initials: T
authors.lastname: Holm-Larsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D005060:Europe; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D053158:Nocturia / Q000175:diagnosis* / Q000188:drug therapy*; D011788:Quality of Life; D014481:United States; D055815:Young Adult