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Symptom improvement and predictors associated with improvement after 6 weeks of alpha-blocker therapy: An exploratory, single-arm, open-label cohort study
- Source :
- PLoS ONE, PLoS ONE, 14(7):e0220417. PUBLIC LIBRARY SCIENCE, PLoS ONE, Vol 14, Iss 7, p e0220417 (2019)
- Publication Year :
- 2019
- Publisher :
- Public Library of Science (PLoS), 2019.
-
Abstract
- ObjectivesClinicians should not only know how many patients will benefit from alpha-blocker therapy but should also be able to identify who will benefit. We studied the changes in patient symptoms following alpha-blocker therapy and the predictors of symptom improvement in clinical practice.DesignThis was a single-arm, open-label observational cohort study with a 6-week follow-up.SettingTwenty-two pharmacies in the Netherlands.ParticipantsPatients were eligible for inclusion if they attended a pharmacy with a new prescription for an alpha-blocker from a general practitioner or urologist.Primary and secondary outcomesOutcomes were assessed using the International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire Short Form (OAB-q SF), and Patient Global Impression of Improvement (PGI-I). Demographic, disease-related, and drug-related information were collected to identify predictors of symptom improvement. These predictors were then assessed by logistic and linear regression analyses of both the original data set and an imputed data set that accounted for the missing variables.ResultsDuring the study, 37% of patients with lower urinary tract symptoms perceived clear symptomatic improvement based on the results of the PGI-I. Improvement was more likely in those who still used alpha-blockers at the end of the 6-week study period and in those who used multiple medications. Although symptom scores decreased significantly on the IPSS and OAB-q SF, the only predictor of change was the pretreatment symptom severity.ConclusionsApproximately one-third of our cohort perceived symptom improvement on alpha-blocker therapy. However, we identified no clear predictors of who might benefit from alpha-blocker treatment, indicating that alpha-blockers should still be prescribed on a trial basis.
- Subjects :
- Male
Time Factors
Medical Doctors
Health Care Providers
030232 urology & nephrology
Cohort Studies
Mathematical and Statistical Techniques
0302 clinical medicine
Surveys and Questionnaires
Medicine and Health Sciences
Medicine
Medical Personnel
030212 general & internal medicine
Hypertonic
Netherlands
Aged, 80 and over
Multidisciplinary
Pharmaceutics
Physics
Statistics
Classical Mechanics
Middle Aged
Prognosis
Professions
Treatment Outcome
Overactive bladder
Physical Sciences
Cohort
Regression Analysis
Female
International Prostate Symptom Score
Alpha blocker
Anatomy
Symptom Assessment
Research Article
Cohort study
Adult
medicine.medical_specialty
Science
Urology
Bladder
Pharmacy
Research and Analysis Methods
03 medical and health sciences
Exocrine Glands
Drug Therapy
Lower Urinary Tract Symptoms
Osmotic Pressure
General Practitioners
Lower urinary tract symptoms
Physicians
Internal medicine
Pressure
Tonicity
Humans
Statistical Methods
Medical prescription
Adrenergic alpha-Antagonists
Aged
Urinary Tract Physiological Phenomena
Urinary Bladder, Overactive
business.industry
Biology and Life Sciences
Alpha-Adrenergic Antagonist Therapy
Renal System
medicine.disease
Health Care
People and Places
Quality of Life
Prostate Gland
Population Groupings
business
Receptor Antagonist Therapy
Mathematics
Follow-Up Studies
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....cf112554657d6cfe7398944d3771ff24