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비뇨의학 전문의에 의한 전립선비대증 관련 약물 처방 현황: 국민건강보험 코호트 기반 연구 |
| 고려대학교 안산병원 비뇨의학교실 |
| 최훈, 유정완, 이영훈, 전병조, 한재현, 태범식, 박재영, 배재현 |
Objective: To analyze the prescription pattern for benign prostatic hyperplasia (BPH) based on the clinician's urology specialty.
Methods: We analyzed the data of patients treated with BPH from the National Health Insurance Database-Cohort (NHIDB) from 2002 to 2013. The information about the type of prescription, including the number and type of medicines according to the physicians’ specialty and chronologic changes were reviewed.
Result: There were over 6 times more BPH patients in 2013 than 2002. In total, 82.0% of patients aged less than 50 years received urologic medicine, while only 49.7% of patients aged over 80 years received urologic drugs prescribed by a qualified urologist. The prescription rates of alpha-blockers by non-urological clinicians were 40.5% in 2002 and 36.9% in 2013; these figures were relatively stable over the 12 year study period. In addition, the rates of anticholinergic and 5-alpha-reductase inhibitors prescribed by non-urological clinicians were 25% and 30%, respectively. The rates of BPH medication prescription by non-urologic experts were highest from internal medicine specialists (58.4%), and by those working in the fields of dermatology (8.3%), family medicine (8.0%), and general surgery (7.2%). With regards to anticholinergics, propiverine was prescribed most frequently followed by tolterodine, solifenacin succinate, fesoterodine, oxybutynin, and trospium. The proportion of prescriptions by non-urologists to urologists was 11.7% for solifenacin and 12.2% for fesoterodine. The proportion of prescriptions by non-urologists to urologists for propiverine, oxybutynin, and trospium was 24%, 30.2%, and 31.9% respectively. The prescription frequency of dutasteride was much lower than finasteride (56147 versus 262930), and the proportion of prescriptions by non-urologists to urologists was much lower in dutasteride (15.7%) versus finasteride (39.3%).
Conclusion: BPH prescriptions by non-urologists in Korea require to be verified by proper scientific values and more attention should be given to improve the quality of BPH care. Data from this study will ultimately lead to the evidence-based medication that could lead to more advanced BPH management, regardless of the clinical specialty of the attending physician.
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keywords : Prostatic Hyperplasia, Prescriptions, Urologists |
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