Changes in benign prostatic hyperplasia management in Valencia: A real-world evidence analysis

Introduction and objectives: A training program was developed to increase general practitioners' engagement in the optimal management of benign prostatic hyperplasia (BPH). The goal of this study was to evaluate changes in BPH management after the implementation of a training program. Material and methods: This observational retrospective cohort study was conducted between 2019 and 2020. Aggregated data were analyzed in 3 evaluation periods (2010, 2012 and 2015), addressing quality indicators for diagnosis, treatment, and treatment outcomes. Results: Overall, 118,795 patients who presented any data points were included. All quality indicators (number of IPSS and PSA determinations) increased between the first period and the last. Combination (alpha-blocker + 5-ARI) therapy was increasingly prescribed during the study periods whereas the proportion of prescriptions for single -agent alpha-blocker showed no significant differences among the periods analyzed. However, the total number of patients eligible for combination therapy who actually received this treatment was low in all periods (7.5, 17.9, and 20.1%, in 2010, 2012, and 2015, respectively). The outcome indicators revealed a decrease in referrals to the Urology unit mostly among newly diagnosed patients. Even though the proportion of patients who underwent BPH-related surgeries increased significantly from the first to the second period, the number of surgeries remained stable between the second and third periods. Conclusions: The training program had a generally positive impact on the management of BPH patients in primary care, but the overall study period may be insufficient to show an effect on some outcome indicators such as the number of surgeries. (c) 2024 The Authors. Published by Elsevier Espa & ntilde;a, S.L.U. on behalf of AEU. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).