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
翁慧鈴、廖俊後、郭漢崇
花蓮佛教慈濟醫院泌尿科
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
Purpose:
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.
Results:
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)
Conclusion:
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.