長期追蹤使用甲型阻斷劑合併 5-α-還原酶抑製劑 在於良性前列腺增生病人之治療效果，服藥順從性及自行停藥的預測因子
Long-term combined α –blockers and 5- α –reductase inhibitor in bph-therapeutic effects, adherence, and predictors for withdrawal of medication
Hueih Ling Ong 1, Chun Hou Liao2, Hann-Chorng Kuo1
Department of Urology1, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
Department of Urology2, Cardinal Tien Hospital and Fu-Jen Catholic University, New Taipei, Taiwan
To investigate the long-term therapeutic effects, patient adherence of combination therapyof 5-α-reductase inhibitor (5ARI) and alpha-blocker, and the predictors for withdrawal of medication in patients with clinical benign prostatic hyperplasia (BPH).
Materials and Methods:
BPH patients with lower urinary tract symptoms (LUTS) under combination therapy were retrospectively analyzed from 1 to 12 years span. The therapeutics effects were assessed by International Prostatic Symptoms Score (IPSS) and quality of life index (QoL-I), total prostatic volume (TPV), maximum flow rate (Qmax), voided volume (VoL), prostatic specific antigen (PSA) at baseline and annually. The reason and predictors of discontinued combination therapy were also investigated.
A total of 625 patients aged 38 to 97 (mean 73) years where enrolled retrospectively with at least 1 year and the longest period of 12 years follow-up. The mean year follow up was 3 years. All measured parameters showed significant improvement after combination therapy. The mean year of discontinuation of combination therapy was 2 years. Whereby, the most common reason for discontinuation of combination therapy was converting to single medication (19.8%). Age did not influence the adherence rate (p < 0.484), but the QoL-I was a predictor to adherence of combined therapy. (p=0.000)
The patient received combination therapy showed significant improvement in all the measured parameter. The most common factor of discontinuation of combination therapy was converting to single medication. QoL-I after treatment lead patient adheres to combination therapy.