Benign prostatic hyperplasia

Improving adherence in men with lower urinary tract symptoms due to benign prostatic hyperplasia

Background

  • The incidence of male lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) increases linearly from 45 years (3.5%) to 85 years (35%)
  • BPH affects the quality of life of 40% of men in their fifth decade and 90% of men in their ninth decade
  • Medical treatment increases the interval between first diagnosis and prostatic surgery to postpone - and even prevent - the need for surgical intervention

The Challenge

  • 50% of men who are prescribed an alpha-blocker for LUTS stop treatment within three months
  • Poor adherence is partly due to a lack of understanding of the latency of effect, so treatment is perceived as ineffective, and partly due to unwanted side-effects
  • Misunderstanding treatment and the risks associated with non-adherence

How Patient Connect helped

The patient support programme aimed to control patient expectations by:

  • Telling men when they were likely to start noticing a benefit from their treatment
  • Emphasising the importance of persistence
  • Explaining how to manage side-effects such as dry mouth
  • Pointing out that stopping treatment would cause their symptoms to revert to pre-treatment severity

Our clinical team developed tailored clinical messages tackling these issues of adherence

Our UK network of 6,500 pharmacies were alerted to the adherence challenge

The pharmacist verbalised the tailored clinical messages to patients at the point-of-dispensing the target medication

Results

From month one of the programme dispensed volumes increased steadily; by month 20 of the programme, growth in our active pharmacies was 27% greater than in our inactive (control) pharmacies, suggesting that the programme had a positive effect on medicine adherence.